VHA System Improves Care, Reduces Medical Errors

The Veterans Health Administration, which has been "known for bloated bureaucracy and poor patient care," is "leading a nascent movement" to "unlock the data lurking in hospitals" through a network of patient information that could help doctors improve patient care and reduce medical errors, the Wall Street Journal reports. In the late 1990s, the VHA spent hundreds of millions of dollars to outfit hospitals and outpatient centers with personal computers that allow doctors to "customize their notes and minimize the ... need for typing skills." As a result, doctors can find patient records, prescriptions and test results "easily," and their test results can "be graphed to show patterns over time." Doctors also can access reports from medical specialists and use the information to coordinate care for patients. The VHA also has installed bar code scanners in 170 hospitals nationwide to match patients with their prescriptions to help prevent medication errors. According to an in-house study, the bar code system reduced medication errors by 70% in a Topeka, Kan., hospital. In addition, the VHA joined forces with the National Aeronautics and Space Administration in 1997 to develop a system for reporting medical errors based on a system used in the aviation industry. In 1998, the VHA established the National Center for Patient Safety to develop a "culture of safety" at the agency. The center trains doctors to study and avoid medical errors and encourages health professionals to "fess up to mistakes, rather than bury them, so that they can be quickly investigated and won't be repeated." The VHA also has united researchers and physicians to discuss the latest medical literature and identify the "best treatments" for a number of diseases and has begun to track physician performance and use the information to "show them how to do better."

The Wall Street Journal reports that the VHA has used the agency's "big budget" and 1,300 hospitals nationwide "in a way that no other health care system can" and has emerged as a "visionary leader" in the health care industry. Most private hospitals have "no standardized information technology that would allow everyone to swap data." In addition, most facilities "typically make more money treating disease than preventing it" and have "little incentive to spend heavily" on a system that could improve patient care but would not "promise clear financial rewards." The Journal also reports that the VHA has made a number of reforms in the past few years despite efforts by veterans groups, lawmakers and researchers -- "each with their own competing agendas" -- to "thwart" plans to "modernize" the agency (Rundle, Wall Street Journal, 12/10).