The Department of Veterans Affairs has a lot on its plate. From its rocky path towards interoperability with the Department of Defense to a disability benefits claims queue stretching into the hundreds of thousands, there is a great deal of work to be done in order to provide service men and women with quality healthcare. To aid the process, the VA hires contractors in the private sector, one of which is CACI International, which has been focusing on digitizing the millions and millions of pages of paper health records collected by the VA over the last few decades. Rick Dansey, Executive Vice President of the Federal Civilian Services Group, sat down with EHRintelligence to discuss the VA’s efforts towards clearing the benefits backlog and integrating their health data with the DoD.
The VA recently announced a big leap forward in dealing with the queue by clearing 97% of the claims older than two years that had been sitting in gridlock. While there are still close to 800,000 claims to go, Veterans Benefits Administration employees and contractors like CACI have been working hard to make progress. “We have some big facilities in Kentucky and Georgia with hundreds of employees doing scanning work,” explains Dansey. “By the end of the project, it’s going to be millions of pages that will be digitized. That goes for another 2 and a half years on the contract, although it could be many years of work after that, depending on how far back the VA really wants to go.”
“There are just a lot more veterans with claims, based on the war for the last ten years. A lot of it is also that when Congress ends up changing some regulations or changing some rules that allows for a broader base of claims for people who are currently getting out of uniform. That also changes the claim for someone who got out in 1985, too. So every change to the rules creates a wave of claims coming in from previous years. It’s not just the last ten years, it’s the last twenty or thirty years. There have just been a lot more. The fact that everything is paper inherently makes it a slower process. So the digitization is going to help in the future.”
Dansey also weighed in on the VA’s efforts to integrate and interoperate with the DoD, a project that has been fraught with setbacks, U-turns, and Congressional anger for the past 18 months. While the two departments have abandoned plans for a single, jointly developed EHR, Dansey doesn’t believe that is much of a problem. “From my vantage point, it is about the data,” he said. “No matter what happens, or who ends up using what system, I don’t think that’s a big problem. In a sense, people get caught up on the system, and it really is about the data. You don’t have to access a single record: all you have to do is pull the right data for the right reasons, and you’ve got what you need.”
“Interoperability is in almost every sentence I read when it comes to what the DoD wants,” Dansey continued. “That’s the focus. And the VA and DoD have common goals. They might have different opinions about how to go about it, but everyone agrees that the data has to be in a standard format so that you can get what you need no matter what system you’re using.”
While Congress has continually pushed for a single system, with one committee even going as far as saying that they will only fund the VA’s budget if there is a joint EHR in the works, Dansey doesn’t believe that the lawmakers themselves are even on the same page. “It’s hard to tell what Congress wants. There’s different language in the bills right now. There are different words. There’s a bill that says ‘single system’, and another that says ‘interoperable, integrated, open source system’. So depending on which committee in which chamber, there are different words even in Congress right now. So I can’t say what the right answer is. You’ve got VA, DoD, and Congress that are trying to figure all that out themselves.”
