It’s VA vs. Department of Defense in health care for our military…with virtually no progress, and military personnel suffering the consequences of “infighting between bureaucracies”

When former Marine Sgt. Chris Morey went to the VA for excruciating back pain and migraines, doctors said they couldn’t do anything for him because they had not received his deployment medical history from the military.

Sgt. Morey, who separated from the Marine Corps in 2007 after serving four years, was told by the Department of Defense that the VA would be sent a copy of his deployment history that included things like a concussion he’d suffered in an improvised explosive device blast during his third tour in Iraq. But that never happened.

“I’m telling you I get headaches; I’m telling you my back is messed up,” he told The Washington Times of his visit to the VA. “You’re telling me it doesn’t matter because it’s not in this record.”

Veterans advocates are urging the Defense Department and VA to collaborate better so electronic health records can simply be clicked and dragged from one system to another when a service member transitions to civilian life, eliminating problems like the ones faced by Sgt. Morey.

While the new secretaries of the Defense and Veterans Affairs departments have publicly said their priority is providing seamless customer service, advocates say they have seen little progress in solving the decade-old divide between the two bureaucracies.

Under the current system, troops are given a compact disc with PDF copies of their health records when they leave the military that they must bring to the VA. The PDFs are essentially just photos of records and can’t be manipulated or updated with current health information

John Stovall, national security director at The American Legion, said implementing a new system to make the transition of medical records easier for veterans should be “a top priority” for leadership.

“It’s easy to see in terms of just bureaucratic infighting or protecting their turf, but, ultimately, it comes down to the positive outcomes for our veterans and service members. It’s a very personal issue to them,” he said.

Mr. Stovall stressed that in addition to increasing interoperability between Defense and VA medical records, it’s also important for the military to use health records that can also be accessed by private doctors.

Sgt. Morey has stopped going to the VA because of “the time commitment that it takes to actually be that squeaky wheel” to get an appointment, but sees private doctors through his employer-provided health care plan. After a VA doctor never followed up on the results of X-rays taken of his back, he has been unable to even get a copy of the X-rays sent to his private doctor.

A soldier at Fort Drum questioned Defense Secretary Ashton Carter about what he’s doing to make sure service members are able to make a smooth, easy transition to civilian life.

“The way I think about it is there’s only one soldier. Why should they have to put up with two Cabinet departments, right?” Mr. Carter responded. “You guys shouldn’t have to see all that. It should be seamless to you.”

But that’s easier said than done.

Both Mr. Carter, who became the leader of the Defense Department in January, and Bob McDonald, who took over the VA in August, have inherited an ages-old problem that has haunted their predecessors: how to restructure their departments to better work with each other and provide veterans with a world-class health service that is transferable from one branch to another without the bureaucratic infighting for turf protection.

Two years ago, the Senate and House Veterans’ Affairs committees sent letters to then-Secretary of Defense Chuck Hagel calling for the Pentagon and VA to adhere to a plan to improve disability claims processing by speeding records transfers to the VA.

At the time, lawmakers were concerned the delay in transferring records slowed veterans’ disability claims by as much as 175 days because it took that long for the VA to receive complete records from the Defense Department.

The 2013 plan required the Pentagon to hand over service treatment records to VA “immediately” and establish an electronic transfer capability for the records by the end of 2013. “Immediately” was translated into a PDF document handed to the veterans upon their release, and the establishment of transferable electronic records is still in progress.

Last year, the Pentagon issued a final request for bids for an $11 billion contract to replace its obsolete electronic health record system and improve data-sharing between it and the VA. However, both branches of the government seem to be moving down different modernization paths.

The Pentagon is working on its Defense Healthcare Management System Modernization program (DHMSM), and the VA is in the process of implementing the next generation of its Veterans Health Information Systems and Technology Architecture, known as VistA.

The DHMSM contract will be awarded in June. PricewaterhouseCoopers is among the bidders, along with IBM and a team consisting of Computer Sciences Corp., Hewlett Packard and Allscripts. Each bidder is working with a different electronic health records vendor. PricewaterhouseCoopers currently runs the VistA health record system.

The Department of Defense aims for initial operational capability for the new system by next year.

In February, the Government Accountability Office (GAO) added the lack of interoperability between the Pentagon and VA health records to its list of “high risk” areas that flags government systems and programs that are particularly vulnerable to fraud, waste, abuse, mismanagement or transformation.

“The two departments have engaged in a series of initiatives intended to achieve electronic health record interoperability, but accomplishment of this goal has been continuously delayed and has yet to be realized,” the GAO said in its report. “The ongoing lack of electronic health record interoperability limits VA clinicians’ ability to readily access information from DOD records, potentially impeding their ability to make the most informed decisions on treatment options, and possibly putting veterans’ health at risk.”

The Pentagon is doing its best to give veterans the best experience possible, said spokeswoman Laura Seal.

The Defense Department “is sharply focused on supporting transitioning service members — this is our commitment to those who serve and their families,” Ms. Seal said in an emailed statement. “Sharing healthcare resources and health information between DoD and VA continues to evolve. This support includes timely and accurate submission of personnel and health information to VA to determine eligibility for benefits and/or demonstrate service connection for disability payments.”

Mr. McDonald told Congress earlier this year that the administration’s $4.1 billion budget request for fiscal 2016 would make progress in efforts to more easily share health records with the Defense Department by “enhancing and modernizing VA’s electronic health record, enhancing data security and achieving health data interoperability with the Department of Defense.”

Walinda West, a VA spokeswoman, highlighted several initiatives the department is working on to better work with the Defense Department, including a joint committee to institutionalize sharing and collaboration, an agreement to share health care resources and a congressionally authorized fund to enhance collaboration from 2003.

The Defense Department was not able to provide a comment.

Joe Davis, a spokesman for the Veterans of Foreign Wars, said that each of the new secretaries has had other issues to deal with since taking over their respective departments.

“They inherited departments in different forms of crises,” he said. “The VA, obviously, is still working hard to overcome its nationwide crisis in care and confidence. DOD is transitioning to a smaller force but with a growing list of requirements and threats, not the least of which is mandatory sequestration returning.”

The board charged with finding ways to improve benefits for military personnel also thought the Defense Department and VA could work together better. One of the recommendations from the Military Compensation and Retirement Modernization Commission, which released its findings earlier this year, suggested the DOD and VA begin using standardized electronic health records and a uniform drug formulary to help service members have a smooth transition out of the service.

The commission found that existing friction between the two bureaucracies can “impair collaboration and reduce cost-effectiveness.”

Veterans agree.

“If I’m this 30-year-old that works more or less in tech, and I can’t figure out all systems I have to go through, what hope does a Vietnam vet have?” said Sgt. Morey. “Now I keep them [VA, DOD] as far away as possible. They’ve been more trouble than they’re worth.”

 

[by Jacqueline Klimas, writing for The Washington Times]

 

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As always, posted for your edification and enlightenment by

NORM ‘n’ AL, Minneapolis
normal@usa1usa.com
612.239.0970

 

 

 

 

 

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