1 / 21

The Veterans Healthcare Administration

The Veterans Healthcare Administration. Rachel Mayo November 28, 2006. Outline. Structure of the VHA VistA – the electronic system of the VA Quality measurement Results of Reengineering Current happenings How can results be replicated?. Who is the VHA?.

dard
Download Presentation

The Veterans Healthcare Administration

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. The Veterans Healthcare Administration Rachel Mayo November 28, 2006

  2. Outline • Structure of the VHA • VistA – the electronic system of the VA • Quality measurement • Results of Reengineering • Current happenings • How can results be replicated?

  3. Who is the VHA? • The VHA is the largest healthcare system in the U.S. consisting of: • More than 1400 facilities (hospitals, clinics, etc.) • 14,800 doctors • 61,000 nurses • 5 million patients

  4. Structure • Cabinet level head (Secretary of VA) • Creates political pressure • Current Under-Secretary: Kussman • VISN – regional network • 22 nationwide • VISNs compete for funding from the national level

  5. Changes Made at the VHA • Change started under Kenneth Kizer • Appointed during Clinton administration • Focused on two main areas: • Efficiency of day-to-day operations • Quality enhancement • Shift from hospital-based → primary care

  6. VistA • VistA – Veteran’s Health Information and Technology Architecture • Composed of four main components: • Computerized Patient Record System • VistA Imaging • Bar-Code Medication Administration • My HealtheVet

  7. CPRS • Computerized Patient Record System • Registration applications • Scheduling • Order tracking system • Patient alerts

  8. VistA Imaging • Digital imaging system • Allows caregivers to access images in any VA facility

  9. BCMA • Bar-Coded Medication Administration • Prevents Prescription Errors • Alerts for Missing Doses

  10. My HealtheVet • Personal Health Record for veterans • Allows documentation of: • Medical History • Family History • Blood Sugars • Journal Entries

  11. Implementation • Started 15 years ago • Eliminated searching for records • Patients in and out faster • No problems after Katrina • End Result: Better Patient Care!

  12. Tracking Performance • Personnel • Clinical Care Activities • Performance Indicators • Internal Review and Improvement • External Review and Oversight

  13. Quality Indicators

  14. Measured Benefits of Reengineering • In 3 years, bed days of care reduced 62% per 1000 patients • Inpatient admissions decreased 32%, ambulatory care visits increased 43% • Staffing reduction of 11% in 4 years • 2700 paper forms eliminated

  15. High Quality Care *596 VA Patients **992 patients at non-VA hospitals

  16. Current Happenings • Kenneth Kizer forced out of job • Limited veterans’ eligibility to system • Surge of mental health patients

  17. Governmental Role • Conservatives worry expanding VHA will cause private sector to tank • Tom Bock – encourage government to pay VHA instead of Medicare • Is this a concept that could work on a grander scale? • Government should consider all angles

  18. Replicating Results • Private sector does not have incentives to create change • Reimbursement “rewards inefficiency” • No incentive to provide good preventive care • The VHA gets to do the “right thing all the time”

  19. Keys to Success • A determined leader • Functional electronic system • Good quality measurement

  20. Summary • VHA – large system, high quality • Award winning electronic system • Quality accountability and tracking • Healthier patients, better care • Not rewarded by government • Changes needed for private sector

  21. Final Thought • “At the VA, you get to do the right thing all the time” – Dr. Peter Woodbridge • Why is this not the case everywhere else?

More Related