Health care industry could learn from VA, says CBO
By Mary Mosquera
Monday, August 17, 2009
Efforts by the Department of Veterans Affairs to improve healthcare quality, even in the face of increasing numbers of veterans entering its system from wars in Iraq and Afghanistan, may have lessons for the overall U.S. healthcare system, according to a recent report from the Congressional Budget Office.
The VA has strengthened its efforts to track performance measures, expand the use of health information technology, manage chronic diseases, coordinate care by different providers and use evidence-based medical practices, the CBO said in the report published Aug. 13.
VA’s VistA health information system includes electronic medical records, computerized physician order entry, medical imaging, lab test results, pharmaceutical management and medical staffing management. CBO said VA has improved data sharing with the Department of Defense in moving toward a single electronic health record. VA and DOD said they plan to share data with commercial providers through use of the federally developed N-Connect portal to the nationwide health information network.
“VistA plays a key role in the agency’s efforts to measure its performance and improve its quality,” said Allison Percy of CBO’s national security division and the report’s author.
Researchers have used clinical data in the VistA system to study the effects of quality improvement strategies. For example, VA medical centers use VistA’s computerized patient record component to track how physicians adhere to clinical practice guidelines. VA’s experience shows that when management concentrates on key quality indicators it can improve the performance of those measures, such as reducing duplicate lab tests and making sure that patients have the recommended vaccinations.
VA developed its VistA system internally, at the local level and over many years. It is unclear how easily outside organizations can adopt the system, although a few have, the report said. VA should make widely available the lessons it learned from VistA, the report suggested.
Electronic health records may not guarantee overall improvements in quality, however, unless policymakers encourage the adoption of systems that are specifically designed to improve healthcare quality.
The report is at www.cbo.gov/ftpdocs/104xx/doc10453/08-13-VHA.pdf
