The Department of Veterans Affairs (DVA) has an opportunity to begin a new chapter. New leadership, along with new authority provided by the passage of “The Veterans Access, Choice and Accountability Act of 2014” provides critical funding for care, new capacity, as well as new tools to improve employee performance across the VA system.
The challenge is enormous, yet the work is sacred.
As the president and CEO of the nation’s largest nonprofit and largest Catholic healthcare system, many of our hospitals, through existing contracting mechanisms, have already been providing access to health services not available at nearby VA medical centers or clinics.
We could spend time debating whether the VA system should be entirely privatized or whether funds should go to building capacity and infrastructure so that that there is no need for there to be dependence on the private health care sector.
I don’t believe that we need to focus on these two different views right now because it would be hard to do either in the time frame needed to respond to the current crisis. Providence Hospital in Washington DC was created to care for the citizens of the nation’s capital but right from the start, the hospital threw its doors open to the wounded soldiers from the Civil War. Three weeks after the hospital opened, it received the first military casualties on July 2.
As we work together to solve the current crisis, the VA should take advantage of existing resources in the private sector but we, the private sector, need to be extra mindful that we are being asked to provide care for some of the most vulnerable among us.
We should focus on creating a solid public-private partnership that responds to the current crisis and begins to build a system of health care for veterans that can seamlessly tap into the private health care system when VA capacity is overloaded, when access to a VA facility is not possible due to distance, or when certain specialty care services are not otherwise available.
Here are a few issues that I believe need to be addressed as the VA takes up this challenge.
First, veterans need to have special assistance made available to help them navigate back and forth between civilian healthcare systems and the VA. Lack of clinically coordinated care is not just an issue for veterans but because it is a population with complex medical needs and includes many aging veterans it is especially important for there to be designated points of contact to ensure that a veteran does not get “lost” in either system.
Medical records need to be transmitted safely and securely to private health care systems and repatriated back to the VA after care is provided. Interoperability of clinical medical records between providers is a challenge but we have the technology to make this happen and I am confident that we can make it work. But it needs careful oversight and attention.
Quality metrics should be the same regardless of where a veteran is seeking care. By holding providers in and outside of the VA system, accountable to the same quality metrics providers will be incentivized to collaborate and coordinate on a veteran’s care.
Finally, it is important to acknowledge that veterans have unique needs related to their service. Health care providers need to be specially trained and educated to recognize health issues that are unique to veterans. The VA has a curriculum designed to help non-veteran providers better understand and treat veterans, called the “Veterans Health Care Initiative.” This sort of training should be mandatory for any civilian health care system that expects to care for a large number of veterans.
This past July, a former Marine died at one of our hospitals in the Austin, Texas area. He did not have any family and few friends. Yet more than a hundred people came to his memorial service, organized by our hospital staff, in honor of his memory and his military service. The Marine Corps honor guards, veterans, the Patriot Guard Riders motorcycle group, police officers, public officials, hospital staff and others touched by this veteran’s circumstances gathered to honor him. He received full military honors at the service, where a U.S. Marine Corps honor guard played taps and held aloft an American flag and guests stood silently, many saluting.
Our veterans deserve the best care we can offer. That’s not the sole responsibility of just the VA system – that’s the responsibility of all caregivers, whether government or private, for profit or nonprofit. We owe it to our men and women in uniform.
Tersigni, EdD, FACHE, serves as president and CEO of Ascension, the nation’s largest nonprofit and largest Catholic healthcare system.