11 december 17, 2008 gail graham vha oi deputy chief officer healthcare information management vha...
TRANSCRIPT
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December 17, 2008
Gail GrahamVHA OI Deputy Chief Officer Healthcare Information Management VHA Office of [email protected]
Capitol Hill Seminar Series: Using Telehealth and Health IT to Deliver Using Telehealth and Health IT to Deliver Quality Care to VeteransQuality Care to Veterans
Overview of Veterans Health Overview of Veterans Health Administration ActivitiesAdministration Activities
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Veterans Health Administration (VHA)Veterans Health Administration (VHA)
“To honor
America’s
veterans by
providing
exceptional health
care that improves
their health and
well-being”
Honoring Those Who Served
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Medical care: In 2007, we cared for 5.5 million veterans
Training: We are among the largest providers of health professional training in the world
Research: We are among the largest and most productive research organizations in the U.S.
Disaster Assistance: We are a principal Federal asset for providing medical assistance in major disasters
Homeless Care: We are the largest direct-care provider for homeless persons in the U.S.
VHA: Key Contributor to Nation’s HealthcareVHA: Key Contributor to Nation’s Healthcare
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Who Are Department of Veterans Affairs (VA) Patients?Who Are Department of Veterans Affairs (VA) Patients?
Older
• 49 % over age 65 (increasing population > 85)
Sicker
• Compared to Age-Matched Americans
- 3 Additional Non-Mental Health Diagnoses
- 1 Additional Mental Health Diagnosis
Poorer
• ~ 70% with annual incomes < $26,000
• ~ 40% with annual incomes < $16,000
Changing Demographics
• 4.5% female overall
- Females: 22.5% of outpatients less than 50 years of age
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278,566 FTE Employees including:
Veterans
Reservists
Physicians
Pharmacists
Nurses
Dentists
Who Are VHA Personnel?
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VVeteranseterans HealthHealth IInformationnformation SSystemsystems andand TTechnologyechnology AArchitecture (VistA)rchitecture (VistA)VVeteranseterans HealthHealth IInformationnformation SSystemsystems andand TTechnologyechnology AArchitecture (VistA)rchitecture (VistA)
• Single, integrated Computerized Patient Record System (CPRS) used throughout VHA in all healthcare settings (Inpatient, Outpatient, Long-term care)
• Delivers an integrated record covering all aspects of patient care and treatment
VistA is:
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Key VistA Patient Comparison Statistics through September 2008Key VistA Patient Comparison Statistics through September 2008
Orders
Images
TIU Documents
Medication Administration
Vital Sign Measurements
2,028,271,561
1,019,783,809
1,138,044,845
1,074,151,892
1,351,435,897
1,054,916
1,306,635
756,082
623,282
815,839
1,016,304
1,174,706
722,675
605,955
789,611
3.80%
11.23%
4.62%
2.86%
3.32%
Total Number of File Entries (through Sep 2008)
Average daily primetime file entry change (through Sep 2008)
Average daily primetime file entry change (through June 2008)
Average percentage rate of file change (June 2008 - Sep 2008)
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InnovationInnovationInnovationInnovation
• Innovation will allow innovative ideas to emerge from the field, and enable the field to build communities of interest to identify and promote the ideas that have the most promise.
• The program will use innovation IT dollars to attain hardware, software and contract development resources for field based development, and Medical Care dollars for program management, stakeholder interaction, encouraging innovators, and evaluation.
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VHA Assets – Healthcare Delivery Sites
•Hospitals
•Clinics (Hospital, Community-Based and Independent)
•Nursing Homes
•Readjustment Counseling Centers(Includes 20 brand new centers with three more opening soon)
•Domiciliaries
•Mobile Clinics
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CBOCS Improve:
Facilitate transition from hospital to primary care
New Clinics Announced:VA announced on 12/4/08 that it plans to open 31 new outpatient clinics in 16 states. They will be operational by late 2010, with some opening in 2009
VHA – Community Based Outpatient Clinics (CBOCS)
• Quality of care• Access to services• Efficiency of operations• Veteran Satisfaction
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VA Electronic Health RecordMy HealtheVet
Personal Health Record• VistA/CPRS is the authoritative VA
medical record• Veteran "owns" his/her
My HealtheVet Personal Health Record (PHR)
• Veterans will access extracted data sent to My HealtheVet from VA Electronic Health Record (EHR)
• Veteran controls access to information (via delegation)
CPRS VistA BCMAVistA Imaging
InformEngageActivate
Complementary Health RecordsComplementary Health Records
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April 19, 2023 13
On-Line Prescription RefillsOn-Line Prescription Refills
Over 3.4 Million Prescription Refills Processed Through My Healthe Vet 2007 Rx Refills up 57% for January - July
123,708117,281
141,554
149,677 150,306
115,425
146,776
123,051
164,317 162,103
170,404174,144
200,535
174,336
200,427
213,618
227,798 227,630
242,317
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
225,000
250,000
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2006 2007
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April 19, 2023 15
Emerging National Healthcare Delivery TrendsEmerging National Healthcare Delivery Trends
• Patient-Centered Care• Decentralized Healthcare
– Networked Virtual Organizations (NVO)• For accessing Consumer Health Information
• Point-of-care Health Information Exchange – Personal Health Records
• Pharmacogenomics & Genomic Medicine• Nanotechnology and Medical Devices• Telehealth & Teleradiology
Nanotechnology for CancerCell Directed Drug DeliveryNanotechnology for CancerCell Directed Drug Delivery
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““Veterans’ hospitals Veterans’ hospitals used to beused to be a a byword for second-rate care or byword for second-rate care or
worse. Now they’re national worse. Now they’re national leaders in efficiency and quality. leaders in efficiency and quality. What cured them? A large dose What cured them? A large dose
of technology.” of technology.”
- Fortune, - Fortune, May 15, 2005May 15, 2005
Best Healthcare AnywhereBest Healthcare Anywhere