VETERAN HEALTH ADMINISTRATION

Veteran Health Administration

Veteran Health Administration

Introduction

The Veteran's Health Administration (VHA) is the largest integrated healthcare system in the United States today. It provides care for over 5 million veterans across the country. The VHA has proven itself to be a leader through distributing quality care at efficient prices. The image of the VHA changed for the better under the hands of Kenneth Kizer, former Under Secretary for Health. More and more veterans are choosing the VHA as their source of healthcare, leading to strains on the system's budget. Limits were placed on the types of patients who could access the VHA in January 2003. believe that limiting eligibility is a bad thing with a system as cost-effective as the VHA. Other organizations should try to emulate the changes made by the VHA. But they will have to be encouraged by the government to do so.

The size and structure of the VHA system is quite different than most private care organizations. The system includes:

More than 1400 hospitals, clinics and nursing homes

14,800 doctors

61,000 nurses

5 million patients (Waller, 2006) The head of the VHA is a cabinet-level position, creating major political pressure on the system as a whole. The system initially started as a network of hospitals, but grew to include more aspects of care including clinics and nursing homes. Twenty-two regional networks called Veterans Integrated Service Networks (VISNs) have been created since 1995. Most VISNs consist of 7 to 10 hospitals, 25 to 30 ambulatory care clinics, 4 to 7 nursing homes, and 1 to 2 domiciliaries (White, 2006). The number of VA hospitals was actually cut in half over the last decade as the emphasis and money shifted towards preventive care.

Several changes were made in order to improve the VHA system under Kenneth Kizer. Efforts to improve were channeled into two main areas: the efficiency and effectiveness of day-to-day operations and a quality transformation (Kizer, 1999). Probably the most crucial change was implementing an all electronic system. This system, called Veterans Health Information and Technology Architecture (VistA), is in place in every VHA facility across the country. This award-winning system is composed of the following pieces:

Computerized Patient Record System

VistA Imaging

Bar-Code Medication Administration

My HealtheVet

The Computerized Patient Record System (CPRS) allows all caregivers to see any information in the patient's record throughout the hospital. Components of this system include registration applications, an order-checking system, notifications for significant changes in a patient's clinical status, and a reminder system (Dept. of Veterans Affairs, 2006).

VistA Imaging provides a comprehensive look at any radiology or other imaging data for a patient. The added ability to access the history of a patient's imaging data (even if it is from a different facility) has helped improve efficiency in the VA's medical centers. It has also allowed patients at rural clinics better access to specialized doctors, who can view images from anywhere in the system (Dept. of Veterans Affairs, 2006).

The VHA's Bar Coded Medication Administration (BCMA) has made the ...