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Do the Veterans Deserve Better?

March 28, 2013
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Gov. Agencies fail at integration, evidence-based treatment, says IOM report

In a lot of ways, the Department of Veterans Affairs (VA) is an industry leader when it comes to healthcare information technology. We’ve covered this in great length at Healthcare Informatics. There is a rural health IT initiative, real-time locating system (RTLS) technology, MyHealtheVet, and of course, the Blue Button project. That’s just the tip of the iceberg, because there’s a lot more where that came from.

I always assumed that with all of this innovative technology, many of the problems that persist in civilian healthcare weren’t as applicable to the agency. I was wrong. After reading a new report from the Institute of Medicine (IOM), I think it’s clear the agency can do a lot better.

For all of its innovation, the IOM report paints a sharp, critical picture of how the VA and the Department of Defense (DoD) have performed in providing returning veterans with evidence-based medicine upon their return home. While the IOM report says both agencies have been at the forefront in providing “programs and interventions to meet the needs of Iraq and Afghanistan service members, veterans, and their families,” their response has not met the needs of the magnitude of this population's requirements.

Complexity and magnitude are important things to keep in mind. As the report mentions, more than 2.2million troops have served in the wars in Iraq and Afghanistan. Of those who have returned, 44 percent have reported difficulties after they returned. While many of these difficulties are physical, a large percent are mental, with many suffering from posttraumatic stress disorder (PTSD), depression, and substance misuse or abuse.

When it comes to those who do suffer from mental illness, the IOM says it has “serious misgivings about inadequate and untimely clinical follow-up and low rates of delivery of evidence-based treatments” from the VA and DoD. Furthermore, the committee found that the agencies are using first-line interventions that don’t have a scientific evidence base.

There was also criticism directed at the agencies for a lack of integration, something that’s been an ongoing issue in the industry, as we reported a few weeks ago. The IOM researchers say the data captured by the DoD, the VA, and other federal government agencies is relevant to solving the issues of the returning veteran, but it needs to be fully linked and integrated.

“They should link and integrate their databases so they can be used more effectively,” the report’s authors wrote. They didn’t stop there. “Further, the departments should work together to establish a work group to explore interagency coordination, define common goals, establish common policies, and create mechanisms to share data. Safeguarding the privacy and confidentiality of such data is paramount, and privacy experts will need to be involved prior to linking data.”

Integration is something that every provider in the industry can do better. They need to better. It’s imperative if we’re going to build a better healthcare system. And even with an array of innovative technology at their fingertips, the VA (and DoD) are no different.

Please feel free to respond in the comment section below or on Twitter by following me at @HCI_GPerna