VA Honored As Innovator For Medical Records

Paperless System Brings Agency $100,000 Prize

Veterans Administration Secretary Jim Nicholson said the agency is proud of its electronic system for tracking the health records of 40,000 veterans. The system has been used since 1998. (By Mark Wilson -- Getty Images)

When Hurricane Katrina swamped New Orleans last year, the Department of Veterans Affairs medical center there was lost -- but medical records for 40,000 veterans were not.

That is because since 1998, VA medical records have been computerized, stored and tracked electronically, rather than on paper. That allowed VA doctors in far-flung locations such as Houston, Jackson, Miss., and the District to immediately access records for New Orleans area VA patients who relocated, ensuring that they continued to receive the care and prescriptions they needed.

It was just one reason that the VA health information system won an award yesterday for innovative government from Harvard University. The award was one of seven handed out by the Ash Institute for Democratic Governance and Innovation at Harvard's John F. Kennedy School of Government, each carrying a $100,000 prize. The annual awards are administered in partnership with the Washington-based Council for Excellence in Government.

"This is a proud day for us," VA Secretary Jim Nicholson said. "The VA is now at the forefront of America's health-care industry."

The award provided a rare day of good news for VA, which has been reeling from the May 3 theft from an employee's home of a laptop that contained names, birth dates and Social Security numbers of millions of veterans and active-duty military members. The laptop was recovered last month, but lawmakers and veterans groups continue to criticize information security practices at the agency as inadequate.

VA and other winners were selected from more than 1,000 entries, including 200 federal programs, said Carl Fillichio, a vice president at the council. Programs were judged on novelty, creativity, effectiveness and significance. The cash award must be used to show others how the winning idea works.

Stephen Goldsmith, a former Indianapolis mayor who is director of the Innovations in American Government Awards, said, "Too often the public sees the mistakes of government officials and not the many successes."

According to VA, the records system, known formally as the Veterans Health Information Systems and Technology Architecture, enables physicians to review a patient's medical history, diagnoses, medications, charts and X-rays at any of 1,400 VA sites.

The system substantially cuts down on errors in the prescription of drugs, curbs repetitive and unnecessary tests, and helps identify patients who need vaccinations and other services, VA officials said. Patients no longer need to recite their medical history every time they see a new doctor, and they can log in to the system to review their files.

"Health care -- the safety, the effectiveness, the efficiency and the compassion -- is improved when one uses the tools of the 21st century," said Jonathan B. Perlin, the VA undersecretary for health.

The system costs $87 per patient each year, a total of more than $669 million annually. But VA officials said the benefits in improved health and reduced expenditures far outweigh the costs. For instance, the system has saved 6,000 lives by improving rates of pneumonia vaccination among veterans with emphysema, cutting hospitalizations for pneumonia by half and saving $40 million annually, they said.

VA is hardly the only medical provider to use computerized records, but it is considered a leader in the field, VA and Harvard officials said.

Perlin said that, in view of the recent data theft, "all of us are heightened in terms of our sensitivity to security." He said users' identities must be authenticated before they can view electronic medical records, and the system keeps a log of everyone who has viewed a particular file. Asked whether allowing patients to view their records makes the system vulnerable to unauthorized access, Perlin said, "The patient has to treat his personal health record the same way he would treat his ATM card."

Another federal winner was the U.S. Fish and Wildlife Service's grass-roots conservation program, which provides technical and financial assistance to private landowners in the West who voluntarily agree to preserve habitats for wolves, grizzly bears, trout and other wildlife. The program, for instance, might help a rancher construct a shrubbery fence and provide alternative sources of water if grazing livestock threaten fish in a stream, said Greg Neudecker, a wildlife biologist with the Fish and Wildlife Service.

"Instead of taking a traditional regulatory approach, we've sort of spun that around to say, 'We're here to help you do good things on your land,' " he said.

Other winners included the District's Metropolitan Police Department for its Gay and Lesbian Liaison Unit; the city of Indianapolis for a charter school initiative; the state of Connecticut for a housing initiative that targets homeless people suffering from addiction or mental illness; Massachusetts for a program that creates teams of social workers to work with needy families; and the School Board of Broward County, Fla., for a program that recruits, trains and retains aspiring teachers for predominantly poor and minority schools.