The healthcare delivered by the Department of Veterans Affairs’ more than 1,200 hospitals and outpatient facilities around the country routinely gets praised by the patients who go to them.
Scott Blackburn, the VA’s Executive in Charge, Office of Information and Technology, is glad the care is so good. He had back surgery at the VA hospital in Baltimore, and was very pleased with the experience.
“But I was little bit surprised at the lack of information and the history that’s not been shared between [the Defense Department] and VA,” he told the audience during the opening keynote panel at AFCEA Bethesda’s 10th annual Healthcare IT Conference. “I think the quality of experience is absolutely terrific, but it could be so much better if we had that information flow.”
Blackburn’s anecdote sums up the theme of the day: How the military medical community, in its broadest sense, is working hard to encourage collaboration among all its parts, including streamlining networks and reducing the number of legacy systems that require too many resources in a budget-restricted environment.
Dr. Carolyn Clancy, the Executive in Charge at the Veterans Health Administration (VHA), said one way information is beginning to flow is through its rapidly growing telehealth initiative. “We have psychiatrists in Manhattan [helping] patients in a tiny town in Oregon,” she said. “We don’t have good, reliable metrics yet, [but] we’re focused like a laser on capacity. [One] in five Americans live in a rural area, one in three veterans, [so developing] capacity is driving everything.”
Blackburn said his office is concentrating on the business priorities set by VHA. “These are what we are going to deliver on. This year there are 18 priority projects,” including electronic health records, telehealth, caregivers, homelessness, and suicide prevention.
At the same time, Clancy said the organization is aware that patients’ expectations are changing. “Younger veterans are way past Facebook and other traditional social media,” she said. “What they want is an app to know how late their appointment is running … That means far more to them than our ideas about the traditional clinician-patient relationship.”
Guy Kiyokawa, deputy director of the Defense Health Agency, noted that his agency was created in 2013 and is tasked with taking these multiple infrastructures, networks, systems, medical devices, information flows, and bringing them together
“It’s a worldwide deployment with many stakeholders,” he said. “It’s one of our biggest challenges. Even in the Pacific Northwest [where] there are only four hospitals, we’re working very hard for a common workflow … [After that], how do we bring in all these different records and systems and collapse them to a single system?” Then take those results and figure out how to apply them globally – quite a challenge.
Just as Blackburn’s experience at a VA hospital helps inform his understanding of the challenge, Dr. Don Rucker, National Coordinator for Health IT at HHS, reminded the audience the same is true of every citizen, including Congress.
Take the challenge of interoperability – of networks, medical records, medical devices. “When you talk with members of Congress, they don’t start with interoperability,” Rucker said. “They had their medical records, their parents’ medical records, their child’s medical records, and they had to ferry them across town [to another physician.] That’s really what has floated the boat here.”
The 21st Century Cures Act, signed into law by President Obama in December 2016, thus has quite a few provisions to increase interoperability, Rucker said. “What is very clear is that Congress wants to expand the conversation beyond provider-to-provider exchange of individual medical records … We’re trying to expand interoperability to get patients back in control of their healthcare.”
J.R. Glass, Vice President, Health and Civil Business Unit, CSRA, said the conference reinforced the systemic message that federal agencies should be collaborating on health IT challenges and opportunities, and that the systems integration community should be bringing solutions to the table that ease the challenges of complex operations like collaboration and drive interoperability across agencies.
“The AFCEA Health IT Day is an excellent opportunity for CSRA to get together with our customers from across the federal healthcare community and listen to their individual challenges and to share success stories about how they have been able to implement Next Generation IT and processes to address their needs. ” he concluded.