After a concerted effort, the VA is now approaching its goal of 100% treatment for patients infected with hepatitis C virus (HCV), VA Secretary David J. Shulkin, MD noted at a speech at the AMSUS Annual Meeting. More than 100,000 veterans have been treated for HCV infection, and 90% have been cured. According to Dr. Shulkin, the VA also has seen significant drops in measures of opioid use and homelessness among veterans. Although the VA is no longer focused on completely ending veteran homelessness, the rate has dropped 50% since 2010, and 3 states (Virginia, Connecticut, and Delaware) have eliminated homelessness completely.
According to Dr. Shulkin, the VA currently is the only health care system that publishes its wait times, quality scores, and disciplinary actions taken against employees. That level of transparency is not only unusual in health care systems, but also unprecedented in the federal government, Dr. Shulkin noted. “I am the only cabinet member that publishes my travel schedule,” Dr. Shulkin told the VA, DoD, and PHS audience.
In addition to promoting current VA progress, Dr. Shulkin also outlined his priorities for the VA moving forward. The priorities included:
- Greater Choice. Dr. Shulkin maintained that the VA should not only provide more options for veterans seeking health care, but also facilitate their ability to make better health care decisions. Choice for veterans will mean being able to access care both inside and outside the VA system.
- Modernize the VA. The signature part of VA’s modernization effort has been its decision to adopt the Cerner/GENESIS electronic health record (EHR) system, but it also includes the VA decision to close 1,100 facilities and focus its resources on the remaining facilities. Dr. Shulkin hopes that the combined power of the VA and DoD on a single EHR system will force EHR providers to improve interoperability. In addition, a new program will allow PHS officers to serve in the VA, bringing in much needed public health experience.
- Improve the Timeliness of Services. Currently, 97% of VA appointments are completed within 30 days, 86% are within a week, and 21% are same day. Improving those metrics will require the VA to “double down on technology,” Dr. Shulkin insisted. The VA now sees 700,000 veterans via telehealth.
- Focus Resources More Efficiently. The VA can and should be “world class” in areas where it matters most, Dr. Shulkin argued, including areas like prosthetics, traumatic brain injury, posttraumatic stress disorder, and spinal cord injury. Better coordination with the DoD also will help both health care systems to improve efficiency. A “Caregivers Moonshot” initiative also will allow more veterans to remain at home at end of life.
- Suicide Prevention. While suicide is a public health crisis across the U.S., it is especially acute amongst veterans. According to Dr. Shulkin, reducing veteran suicide will require action both inside and outside the VA. The VA needs to connect with community mental health providers and provide more services to other than honorable discharges.