When editor Donna passed an item from iHealthBeat to me, her comment was “Just as the DOD and VA are fighting over systems, maybe VA can make a few pounds selling VistA to the NHS!” Well, it’s much more interesting than that!
The iHealthBeat item is about a £285,000 ($430,000) exchange programme – of “leaders, staff and ideas” – to see what people from NHS England and the Veterans Health Administration (VA) could learn from each other about digital records and technologies. (This follows the scandalously expensive collapse in 2011 of the NHS’s attempt to develop its own national electronic record system.) Digging around some more, we discover from an item by eHealthInsider that the exchange programme began as part of the 3millionlives (3ML) initiative to compare notes on telehealth monitoring. With 3ML now being incorporated into NHS England, we find that the extended remit of the exchange programme has relegated telehealth to what many seem regard as its proper place in the scheme of things – the sidelines.
Department of Veterans Affairs IT systems have been breached since 2010 by eight ‘nation-state-sponsored organizations’, affecting records of 20 million veterans, according to recent testimony in hearings held earlier this month by the House Veterans Affairs Oversight and Investigations Subcommittee. While the normal ‘hack’ is due to theft or an inside job for financial gain, these likely have a far more sinister nature. According to former VA Chief Information Security Officer Jerry Davis (now at NASA), the attacks continue from these countries, and according to Subcommittee Chairman Rep. Coffman, may include China and Russia. Testimony and evidence also revealed that those responsible for informing Secretary Shinseki may have understated the problem. The VA has certainly been taking its lumps with a Magic 8 Ball of late, with a derailed joint EHR project with the Department of Defense and wrangling on who’s leading integration [TTA 3 April; iHealthBeat]. VA Systems Hacked From Abroad, Was VA Secretary Misled About Breaches? (HealthcareInfoSecurity)
Institute of Medicine, ‘Daily Show’ rap DOD, VA for unlinked EHRs
When the US Department of Defense (DOD) and Veterans Affairs (VA) announced back on 27 February that they would not achieve their major goal since 2009 of a single EHR system by 2017, with initial test next year, for this Editor it was just another billion-dollar ‘fail’ day out of DC. FDA dithers since July 2011 on final guidance on mHealth approval–yawn. Centers for Medicare and Medicare Services (CMS) cutting back rural telemedicine consults–business as usual. Individual health insurance premiums going up 30 percent next year? We knew that was coming! So no surprise here when the Institute for Medicine of the National Academy of Sciences issued a report highly critical of both agencies regarding the needs of 2.2 million Iraq and Afghanistan veterans, with one key criticism the lack of EHR interoperability. According to iHealthBeat:
The IOM report found that:
• 49% of returning veterans have experienced post-traumatic stress;
• 48% have dealt with the “strains on family life;”
• 44% have experienced readjustment difficulties; and
• 32% have felt “an occasional loss of interest in daily activities.”
According to IOM, the federal government’s response to troops returning to the U.S. “has been slow and has not matched the magnitude of this population’s requirements as many cope with a complex set of health, economic and other challenges.”
Neil Versel in his Meaningful HIT News article published yesterday highlighted the EHR single-system fail through, rather incredibly, a Jon Stewart Daily Show video segment called ‘Red, White and Screwed’. (Today, in American life, you know an issue has gone mainstream when it makes a ‘news/comedy’ show such as this or the Colbert Report.) This Editor is no fan for multiple reasons, but to his credit Mr. Stewart has been a strong advocate on behalf of veterans and showcases the failure of veterans’ support regularly on a segment called ‘The Red Tape Diaries’ without sparing a certain Administration from criticism. Aside from over 900,000 veterans waiting an average of 273 days for their disability claims to be processed, the icing on the cake is how the EHR ‘fail’ was announced. At 3:20 in the video, a Government Accountability Office (GAO) official drily depicts both DOD and VA as perpetrators of project mismanagement and poor oversight. And this is despite a 40 percent increase in budget from the Republican-controlled House, which confounded Mr. Stewart. The criticism goes on from there. Magic 8 Ball says ‘messed up, try again.’ DoD-VA integration failure is no laughing matter, even to Stewart Hat tip to reader Ellen Fink-Samnick, MSW of ‘Ellen’s Ethical Lens’ for featuring this article on her LinkedIn group.
Related, ironic note: the DOD’s and VA’s EHRs are respectively called AHLTA and VistA, a nostalgic touch for those of us who used the first real search engine, AltaVista, circa 1996.
The US Department of Veterans Affairs (VA) has two critical vacancies, just announced: CIO Roger Baker and CTO Peter Levin are both leaving the agency after three years. Their resignations come in the midst of major initiatives: Levin’s ‘Blue Button’ PHR (personal health record), mobile telehealth technologies for suicide prevention and oncology; Baker’s adoption of mobile devices and streamlined claims processes. The VA is also coping with the thousands of Iraq and Afghanistan veterans flooding into the system requiring high levels of care, as well as aging veterans of the Korean, Vietnam and Gulf (I) Wars. No word in this article on what will come next from either Baker or Levin, or the VA, which is unusual. Healthcare IT News