Task force recommends fixes for military health system

By Paul McCloskey
01:00 AM
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A presidential task force, created following revelations about mismanagement at Walter Reed Army Medical Center, has recommend ways to keep wounded veterans from falling through recordkeeping gaps between the departments of Defense and Veterans Affairs.

The group, dubbed the "Task Force on Returning Global War on Terror Heroes" and headed by VA Secretary Jim Nicholson, called on DOD and VA to "develop a system of co-management and case management that promotes continuity of care" across the military services and the VA.

Further, it urged government agencies involved in soldiers' health to "collaborate and, in some cases, to co-manage the delivery of services and benefits to injured GWOT service-members and disabled veterans."

That included a suggestion that the military develop a joint process for evaluating a service member's military readiness "in a consistent manner across all military branches in conjunction with the VA disability compensation process."

The task force report concluded there are currently "no formal interagency agreements between DOD and VA to transfer case management responsibilities across the military services and VA."

To support continuity of care, the task looked at several ways to use information technology, although some key programs it mentioned were not new. The task force noted, for instance, that DOD and VA had an existing agreement to collaborate on the development of a joint inpatient electronic health record.

"This initiative will make health care data on shared beneficiaries immediately accessible within both departments," it said.

The task force recommended several steps be taken to ease the handoff of records between the two departments, including expanding VA access to DOD records "to coordinate improved transfer of a soldier's medical care through patient 'handoff.'"

The task force cited three information technology projects that would improve those handoffs:

  • The creation of a DOD/VA interface for health care providers to have access to data on combat theater injured service members.
  • Enhancement of the military's Computerized Patient Record System (CPRS) to specifically track soldiers returning from the war front.
  • The development of a Veterans Tracking Application and identifiers to improve monitoring of returning soldiers.

The task force made several recommendations that specifically address improving treatment for warfighters' trauma conditions, including the creation of a "polytrauma identifier" to help recognize "the additional needs" of injured troops.

It also recommended development of a "Traumatic Brain Injury (TBI) database to track patients who have experienced TBI."

Other suggestions made by the panel, which included the secretaries of Defense, Labor, Health and Human Services, Housing and Urban Development, and Education, included:

  • That HHS' Indian Health Service (IHS) expand coordination on IT interoperability with the goal of adopting standardized data sharing between the VA and IHS health care partners.
  • The creation of an "Embedded Fragment" surveillance center to monitor returning service members "who have possibly retained fragments of materials in order to provide early medical intervention."

In a letter, Nicholson said the recommendations were made with an eye toward those projects "that could be implemented within agency authority and existing resource levels." He also said the focus of the panel was "on timeliness, ease of application and efficient delivery of services."