The Washington Post

Defense, VA to share health record system for service members and vets

Members of a Senate committee expressed concern Wednesday that reforms taken by the departments of Defense and Veterans Affairs have done little to cut the maze of bureaucracy experienced by many service members and veterans trying to navigate the military health-care system.

Based on the testimony, “the bureaucracy we tried to cut through may have become worse,” said Sen. Richard Burr (N.C.), the ranking Republican on the Senate Veterans’ Affairs Committee.

The lack of collaboration between VA and Defense has been the subject of continued scrutiny on Capitol Hill since the scandal over the quality of care provided to wounded service members at Walter Reed Army Medical Center broke four years ago, after a Washington Post investigation.

At the hearing Wednesday, veterans wounded in Iraq and Afghanistan described continued problems with coordination of their medical care.

“What concerns me is why, after so many years, VA and DoD haven’t solved the kind of transition problems I’ve experienced,” said retired Army Spec. Steven A. Bohn, who was badly injured when a suicide bomber detonated a dump truck packed with 2,000 pounds of explosives at his outpost in Wardak province in Afghanistan in 2008.

Bohn was supposed to be sent from Germany to Walter Reed in Washington for surgery, but instead was flown to Fort Campbell, Ky., he said. After the mistake was recognized, he was sent several weeks later to Walter Reed for the surgery. While he convalesced at a spinal care injury unit in Massachusetts, Fort Campbell threatened him with being AWOL, Bohn testified.

As part of the post-Walter Reed scandal reforms, every recovering soldier is supposed to be assigned a senior-level nurse or social worker to help coordinate recovery. Bohn said he was never contacted. “I never even heard about it until a couple of days ago,” he said.

Bohn was medically retired from the Army in October 2010 but has found the same coordination problems in dealing with the VA. He has yet to be assigned a VA primary care doctor, he testified.

Officials with both the Pentagon and the VA said the problems described by Bohn and others at the hearing were unacceptable.

George Peach Taylor Jr., deputy assistant secretary of defense for force health protection and readiness, said the Pentagon and VA have “made demonstrable progress” in repairing the problems.

“We’re heading in the right direction,” he told the committee.

The two departments have formally agreed to create a single, shared electronic health records system for all active-duty service members and veterans, according to a memorandum presented to lawmakers Tuesday.

The single system, known as the Integrated Lifetime Electronic Record, would serve more than 15 million patients, including approximately 9 million active-duty service members, retirees and family members who receive health care from the Defense Department and 6.5 million veterans covered by the VA.

A memorandum dated May 2 and signed by Secretary of Defense Robert M. Gates and VA Secretary Eric Shinseki sets the framework for creating the system and was delivered Tuesday to members of the House and Senate veterans and appropriations committees. A copy was obtained by The Washington Post.

The two secretaries pledged two years ago to pursue a single system in an effort to improve health care for service members and veterans, and the departments have been in intense discussions about a merger since December. The memorandum calls for “a high-level governance” structure, including a program executive selected by both secretaries and an advisory board including leaders from both departments.

A single system will provide a better continuum of care as active-duty troops make the transition to veteran status, officials said. “From the moment they raise their right hand to the moment they are honored in a national cemetery, their record will be available to them,” Roger Baker, assistant secretary for information and technology for the VA, said in an interview Tuesday.

The two departments have spent $10 billion developing separate electronic health records over the past decade. The new system will combine elements of the VA’s Veterans Health Information Systems and Technology Architecture and the Pentagon’s Armed Forces Health Longitudinal Technology Application.

Baker said creating a single system will be a complex project that probably will take four years.

“We’ve got a lot more to do,” he said. “We’re looking at what it’s going to cost and how to implement it.”

Sen. Patty Murray (D-Wash.), the committee chairman, expressed frustration after Wednesday’s hearing about the length of time it took the departments to even forge an agreement on the issue. “It’s taken an agonizingly long time, and we still have a long way to go,” she said. “We have a lot of people who will be coming home in the next four years.”

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