In the past, I have commented on an article by Phillip Longman describing the quality of care at the VA. Mr. Longman recently wrote a book titled The Best Care Anywhere. The book claims that “the long-maligned Veterans Health Administration has become the highest-quality healthcare provider in the United States.”
Gooznews interviews Mr. Longman. Below are some excerpts:
How does contact with the VA healthcare system compare in terms of medical outcomes for its patients? How about in other measures of quality?
In study after study published in peer‐reviewed journals, the VA beats other health care providers on virtually every measure of quality. These include patient safety, adherence to the protocols of evidence medicine, integration of care, cost‐effectiveness, and patient satisfaction. The VA is also on the leading edge of medical research, due to its close affiliation with the nation’s leading medical schools, where many VA doctors have faculty positions. The VA has its problems, but compared to those found elsewhere in the U.S. health care system, it offers “Best Care Anywhere.”
How has the VA managed to create such a successful model when government bureaucracy, political pressures and limited funding would seem to make it impossible?
During the 1990s, VA health care underwent a quality revolution. It was started by frontline doctors and nurses who simply wanted to do right by America’s veterans. It was later propelled by the enlightened and charismatic leadership of Dr. Ken Kizer, who took control of the Veterans Health Administration under President Clinton. The key to making it all work was the VA’s near life‐long relationship with its patients, which means it has incentives as an institution for investing in prevention, disease management, and other protocols that keep patients well-incentives that are sadly lacking elsewhere in the U.S. health care system.
Would a civilian VA mean more and bigger government?
For those who are concerned about the growth of government, and I am one, the most important single objective is to control the cost of health care, which is driving up spending at all levels of government. The more Americans have access to the VA model of care, the lower health care costs will be, while at the same time health care quality will improve. Done right, the widespread adoption of the VA model of care could free up enough resources to pay for tax cuts, or to start making serious down payments on our national debt.
In addition, a recent post on Healthcare IT news cites 26 ideas the VA presents to improve health IT. These include:
- Reducing healthcare associated infections using informatics
- CPRS (Computerized Patient Record System) -based automated queries and reports
- Robust VA forms search engine
- Augment CPRS with standards-based decision support engine
- Enhanced care management to facilitate case management and chronic disease care
- E-discharge pilot program
- CPRS enhancement for veteran-centered care
- Suicide hotline: be a hero, save a hero
- Touch screen device support for nursing triage of patients
- Integrate VistA surgery package with CPRS
- Illustrated medication instructions for veterans
- Share verified insurance info via use of the master patient index
- Accessible contact information for all assigned care providers
- Wireless voice communications with hands free options
- Improved access to military personnel records
- Reduce unnecessary/duplicate lab tests by rules-based algorithms
Is the VA the for a future of health care in America? Maybe, maybe not. But there are certainly lessons the private sector can learn from the VA.