A “Heal The Vet” “Reset” At The VA?

August 27, 2009


This AP story tells us the following…

CHARLESTON, W.Va. — The U.S. Department of Veterans Affairs now estimates that more than 600 veterans erroneously received letters telling them they had been diagnosed with Lou Gehrig’s disease, VA spokeswoman Katie Roberts said Thursday.

As a result of the panic the letters caused, the agency plans to create a more rigorous screening process for its notification letters and is offering to reimburse veterans for medical expenses incurred as a result of the letters.

“That’s the least they can do,” said former Air Force reservist Gale Reid in Montgomery, Ala. She racked up more than $3,000 in bills for medical tests last week to get a second opinion. Her civilian doctor concluded she did not have ALS, also known as Lou Gehrig’s disease.

ALS is a rapidly progressive disease that attacks the nerve cells responsible for controlling muscles and typically kills people within five years.

This takes us to the VA home page where there is a Q&A on the ALS-related mixup at the bottom, including the following (the explanation provided here is a computer glitch)…

Why did Veterans who do not have ALS get letters?

• VA used data and information from its data base to identify Veterans diagnosed with ALS or who had filed a claim for ALS, but were not currently receiving disability compensation benefits for the condition. However, as a result of problems in the codes VA used to identify these Veterans, VA sent the letter to some Veterans who do not have ALS.

What is VA doing to correct the mistake?

• We are working to identify the specific problems that caused the misidentification of Veterans records. We will ensure any future data extracts for similar outreach purposes are properly formulated and independently validated to prevent these types of problems in the future.

What will VA do to prevent this from happening again?

• As a result of this incident, VA is creating a more rigorous process that includes thorough and careful screening of the data, comprehensive review and approval process that will include involvement from our stakeholders before release of notifications letters.

This 2005 story tells us that Bushco and the Republican-controlled Congress tried to make changes to the VA’s computer recordkeeping system, but ran into predictable results…

A $3.5-billion computer overhaul at veterans’ hospitals across the country is poised to fail unless the Department of Veterans Affairs makes drastic changes, according to a closely guarded government study obtained by the St. Petersburg Times.

The multiyear project is designed to modernize almost all phases of hospital computing at the VA, including appointment schedules, lab reports, drug prescriptions and a clinical record system already widely admired as one of the best in the world.

But a February report by Carnegie Mellon University, which the VA hired to evaluate the computer conversion, says the ambitious undertaking – known as HealtheVet, or HeV – is “not viable” and an “unacceptably high risk.”

And if the project fails, the VA could not deliver timely medical care to 5-million veterans, another internal VA document says. The result would be “gridlock.”

“The VA must rethink HealtheVet,” says the Carnegie Mellon report. “Current plans are not realistic given the complexity and magnitude of HeV and the VA’s ability” to carry out those plans.

And this story from about a year ago tells us that “HealtheVet” was “far from complete,” in particular…

Without an integrated plan that includes independently validated cost estimates, VA increases the risk that HealtheVet could incur cost increases and continued schedule slippages and not achieve its intended outcomes. Various levels and types of oversight are currently being provided for the HealtheVet initiative by business owners, developers, and departmental information technology governance boards. However, the business owners have not yet implemented a complete governance structure, several key leadership positions within the developers’ organization are either vacant or filled with acting personnel, and the governance boards have not yet scheduled critical reviews of HealtheVet projects. Until all elements of governance and oversight are in place, the risk to the success of the HealtheVet initiative is increased.

And it’s not as if former Bushco VA Secretary Jim Nicholson was completely truthful on other agency-related matters to Congress (here and here). But in the matter of “HealtheVet,” Keith Ashdown of Taxpayers For Common Sense said in the 2005 story that…

“At this time of record-high budget deficits, it makes sense that agencies of the federal government be extra vigilant with taxpayers’ money,” Nelson wrote. “Not addressing potential problems with a national health-data repository now could lead to another fiscal disaster.”

“It’s horrifying, billions of dollars at stake and it seems nobody is minding the ship over there.”

I will acknowledge that a conversion of medical data on the scale of “HealtheVet” is a daunting task for anyone regardless of their political affiliation. However, we had years to get this right when we were under Republican “governance,” and the massive ALS screwup, though perhaps not a “smoking gun,” is at the very least evidence that Secretary Shinseki should testify to Congress exactly at what state of operational readiness we are – or aren’t – as this stage of the “HealtheVet” initiative.

(No posting tomorrow, by the way – talk amongst yourselves…)

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