Sunday, January 23, 2011

VA stands for "very accountable"

A mutual friend recently introduced me to Scott Gould, Deputy Secretary of the Department of Veterans Affairs, who informed me that VA has recently posted the performance data for all 153 medical centers at Veteran's Health Administration on the web. Here's the introduction from the website:

Welcome to the VA Hospital Compare web site. This site is for Veterans, family members and their caregivers to compare the performance of their VA hospitals to other VA hospitals. Using this tool, Veterans, family members, and caregivers can compare the hospital care provided to patients.

Imagine that. They are actually inviting people to make comparisons of clinical quality in their hospitals. I am guessing that this kind of transparency gives people in the individual hospitals an extra incentive to do well. As I have often said about transparency, its main value is in holding ourselves accountable to the standard of care we say we believe in.

This is clearly exemplified by the VA. See below for more from the website. I say bravo and congratulations!

The Secretary of Veterans Affairs (VA) and the VA’s Under Secretary for Health are committed to transparency − giving Americans the facts. The Veterans Health Administration (VHA) releases the quality goals and measured performance of VA health care in order to ensure public accountability and to spur constant improvements in health care delivery. The success of this approach is reflected in our receipt of the Annual Leadership Award from the American College of Medical Quality.

Raising the bar for the 21st century healthcare

Much of the data in LinKS and ASPIRE are simply not measured in other health systems – VA is raising the bar. When available, VA uses outside benchmarks but often sets VA standards or goals at a higher level. VA scores hospitals more than 30% different from the goal as underperforming or red and those only 10% different from the goal are shown in green in ASPIRE. But a red site within the VA might be a good performer compared to outside counterparts. The scoring system is designed to move VA forward. ASPIRE is not about finding fault but about helping VA to target opportunities for improving performance.


e-Patient Dave said...

Agree, agree, huzzah huzzah.

I assert that nobody can claim to be a serious thinker about improving delivery of healthcare until they've read Best Care Anywhere, Phil Longman's terrific (yet short!) book subtitled "Why VA Health Care is Better Than Yours." (And this includes you, Mr. Levy.) I read the first edition two+ years ago, I met the author, I watched healthcare for two years, read the second edition last year, and I haven't seen a single thing anywhere to disprove any of its assertions.

The VA has no profit ax to grind, no incentive to do anything except take care of veterans - and they can't kick the can down the road, because by law they have the patient for life. So they only do things that work.

They also were the first to implement the Markle Foundation's "Blue Button" initiative, to let patients download their health data and take it anywhere? When the idea was proposed some people asked "Do patients really want that??" Well, the Blue Button went live on the VA's site on October 8, and three months later 266,000 people had done the download. So yeah, I guess patients do want that.

The VA was also a leader in offering a Web-based personal health record (PHR), My Health eVet. And you know what? You (anyone) can go there and create an account - it's open to the public for anyone to use. I'm planning to do it myself next month.

"Best Care Anywhere" is a great read. Interesting - written by a conservative, it pointedly documents how "government run healthcare" (truly socialized medicine) is producing better results than any commercial system.

That's the evidence, so as I say, I don't think anyone can opine about fixing healthcare without reading this.

So it's no surprise to me that they're also publishing their stats.

(Aren't you glad you asked?)

Anonymous said...

my limited experience working at a VA Hospital leads me to think that more time is spent in front of computer monitors buffing the data rather than caring for patients. can we measure that? and have you ever tried to fire an incompetent employee at the VA? good luck.

Medical Quack said...

Actually the VA does a lot of things right, nobody talk about it enough though I think. I like where any vet can download their health records too and it's going over pretty big with the Blue Button campaign and Medicare now allows this as well.

Medicare.Gov has been putting information out too on both hospitals and doctors and the MD part is rough right now but in time as they work the data bases it will get better. Actually the government site is I think and so do a few others, doing a decent job on getting some information out there compared to what you get from the commercial sites, who's data seems to be riddled with errors to include dead doctors, listing MDs on being on staff at hospitals they have never set foot in and so on.

I have been following the commercial folks along ever since I found my former deceased doctor on their listing who has been gone for about 8 years now, so how often do they update and how did she still take HealthNet insurance without a pulse:)

I had good comments from doctors on this with their numerous errors they have found as well.

The Medicare effort to find and compare doctors is coming along and they even admit it is a bit rough around the edges with their first version so I think there's more valuable information and ratings on the government site, again after what the flaws were on the commercial side and the biggest commercial rating service was bought by a private equity firm last year.

Again, the VA sometimes doesn't always get the kind mentions they deserve.

pesha said...

This is great to hear about the VA and no surprise given its head - Gen Eric Shinseki, the very same former Army Chief of Staff who told the Bush administration flat out that considerably more troops would be needed in Iraq than the Dept of Defense wanted to send--for which he was rewarded by an escort to the door. Shinseki is a straight-shooter, so to speak, and his shining light all over the Dept of Veteran Affairs is consistent with his leadership in the Army.