Wednesday, February 06, 2013

DoD and VA fail yet again -- where is the oversight?

The Defense Dept and the Dept of Veterans Affairs made a little announcement yesterday about medical records which helped add to Barack Obama's existing problem with veterans' medical records.  For example, Politifact weighed in on his 2011 State of the Union speech:


In his State of the Union address on Jan. 25, 2011, President Barack Obama boasted that his administration has made "great strides over the last two years in using technology and getting rid of waste."

And he used the U.S. Department of Veterans Affairs as a prime example. "Veterans can now download their electronic medical records with a click of the mouse," Obama said.

Two days later, the Iraq and Afghanistan Veterans of America (IAVA) posted a response on their website accusing Obama of "mischaracterizing" the VA electronic medical records system.

"This is not true," stated IAVA Founder and Executive Director Paul Rieckhoff. "Contrary to the president’s comment, the only thing a veteran can download from the VA’s system are pharmaceutical records and personal health information that he or she has self-entered. This is a critical distinction.

"The president’s comments are misleading to service members, veterans and the American public, who now think that this system is in place and functional, while it is clearly not. In the last 24 hours, IAVA has heard from hundreds of members, who have expressed surprise and outrage that the president could get something so wrong in arguably the most important speech of the year."


In 2008 and 2012 while running for the Oval Office, his campaign insisted, "Senator Obama passed an amendment that became law requiring the Defense Department to report to Congress on the delayed development of an electronic medical records system compatible with the VA's electronic medical records system. DOD's delay in developing such a system has created obstacles for service members transitioning into the VA health care system."  (You can still find it on this 'Organizing for America' page if you ignore the "sorry wrong page" message and scroll down.)  You can also find the 2007 Obama campaign talking point ("Senator Obama passed an amendment that became law requiring the Defense Department to report to Congress on the delayed development of an electronic medical records system compatible with the VA's electronic medical records system. DOD's delay in developing such a system has created obstacles for service members transitioning into the VA health care system.") re-posted in the comments of this Washington Post article.


So the above should establish that Barack's staked a considerable claim to electronic records that are seamless.  The DoD and the VA have been working on this for some time now.  And?

Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee and her office issued the following yesterday:




FOR IMMEDIATE RELEASE
Tuesday, February 5th, 2012
CONTACT: Murray Press Office
202-224-2834

Murray Criticizes VA and DoD Decision to “Back Away” from Truly Seamless Medical Health Record System
(Washington D.C.) -- U.S. Senator Patty Murray today released the following statement after the VA and DoD jointly announced changes to their plan to pursue a fully integrated electronic medical record system.


“I’m disappointed that the VA and the Pentagon are now backing away from a truly seamless medical records system. While this is a very complex problem, we must provide the best care for our servicemembers and veterans. That means the departments must meet this challenge by working together. What they are now proposing is not the fully integrated, end-to-end IT solution that this problem demands. VA and DOD have been at this for years and have sunk over $1 billion into making this the cornerstone of a nationwide electronic medical records initiative. I intend to follow-up with both Secretaries to find out why this decision was made.”


###
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Matt McAlvanah
Communications Director
U.S. Senator Patty Murray
202-224-2834 - press office
202--224-0228 - direct

 
 
 
RSS Feed for Senator Murray's office


Oh, well some wasted money, right?  How is that new and why does it matter?  Why is this an issue, a service member's records?  What's the real problem?  No one's ever really put out when they go from service member to veteran, right?

Tammy Duckworth: Well what didn't work so well -- this is one of the first things I brought up to [VA] Secretary [Eric] Shinseki when he interviewed me -- was the fact that we did not have a seamless transition of our military records from DoD to VA. When I left Walter Reed with my full medical records and I went to my VA hospital for the first time, I had to strip down to prove that I was an amputee. Even though he could see that I was an amputee and he had the medical records from the surgeon who amputated my legs. And we're immediately fixing that.  Back in May of this year, [Defense] Secretary [Robert] Gates and Secretary Shinseki agreed to a program where we're going to develop virtual, lifetime, electronic records. So that from the day you raise your hand to enlist in the army to the day that you're laid to rest in one of our national shrines, your records follow you. And this will be a momnumental change in how VA and DoD hand off and care for our veterans.

That's Iraq War veteran Tammy Duckworth from November 11, 2009, appearing on The Diane Rehm Show (NPR).  Duckworth was the VA's Assistant Secretary of Public and Intergrovernmental Affairs at that time.  Today?  She's a US House Representative so hopefully she'll be calling out the move by DoD and VA as well.

Not that it will necessarily make much of a difference.  Dropping back to the July 25th snapshot to note that day's House Veterans Affairs Committee hearing:



This morning, US House Rep Jeff Miller noted that "in 1961 John F. Kennedy said we'd put a man on the moon, eight years later, we were there.  We're talking about an integrated electronic health records by 2017.  Why could we put a man on the moon in eight years and we're not starting from ground zero on the electronic health record -- why is it taking so long?" He was asking that of the Secretary of Defense Leon Panetta and the Secretary of Veterans Affairs Eric Shinseki who were appearing before a joint-hearing of the House Armed Services and House Veterans Affairs Committee.  


Of course no real answer was given.  A grinning -- apparently amused -- Shinseki began his non-answer by declaring that "I can't account for the previous ten years."  Though he didn't say it, he also apparently couldn't account for the three years that he's been Secretary of the VA.  Three years and seven months.  You'd think Shinseki would be able to speak to the issue.  He couldn't.  He could offer that he met with Panetta four times this year with plans for a fifth meeting.  This was the same amount he met with former Secretary of Defense Robert Gates but, apparently, in a few months less time.   I have no idea what that or his ridiculous grin was about. 

But I do think Shinseki may have inadvertantly provided an answer for the delay when he went on to declare,  "It's taken us seventeen months to get to an agreement that both Secretary Panetta and I signed that describes the way forward."  There's the problem right there. 


Back in March 2011 what was Shinseki bragging about?  As Bob Brewin (Nextgov.com) reported, "Veteran Affairs Sectretary Eric Shinseki said Thursday he and Defense Secretary Robert Gates agreed on March 17 that their departments would develop a common electronic health record system."  So that was agreed to in March 2011.  But it took Shinseki and and Gates 17 months to figure out how?  There's your time waster right there.  And it was not needed.  Shinseki and Panette did not need to 'invent' a damn thing.  This is not a new issue.  VA has long ago addressed what they need with regards to records and DoD has identified the same.  And after this had been done (and redone), Robert Dole and Donna Shalala served on the Dole -Shalala Commission coming up with many of the same things.  The Dole -Shalala Commission was established in 2007 and formally known as the President's Commission on Care for America's Returning Wounded Warriors.   Appearing before the House Veterans Affairs Committee February 7, 2008, VA's Dr. James Peake testified that this electronic record was "a critical recommendation in the Dole-Shalala Commission report."


DoD and VA need to explain exactly what happened and, in a perfect world, Shinseki would be resigning.  This is only the latest in a series of critical mistakes on the part of VA.  Where is the oversight?


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