WASHINGTON – For three decades, Mike Viterna worked to get members of the military the health care services they needed at bases in the U.S. and around the world. Now he’s fighting to make sure they continue to get fast treatment when they leave the military.
“They’re being underserved,” said Viterna, who was an Air Force medical services manager for 33 years before retiring to become president of the National Organization of Veterans’ Advocates.
Long lines, delays in care and late disability claim payments await military veterans when they return from tours of duty overseas as a result of a disjointed medical record system, with files shuffled between the Department of Veterans Affairs and Department of Defense.
Despite President Barack Obama’s 2009 call for a unified system that would allow the health records of military personnel to follow with them forever, from the battlefield to civilian life, thousands of veterans face extended delays in care as they try to find DoD health records before receiving VA care.
“It compromises our veterans and the care they need,” he said.
Viterna noted that the administrative records snafus add to the backlog of disability compensation claims, which is already nearly nine months, according to the VA.
Officials promised as recently as last July that the ambitious plan to unite the government’s two largest departments electronically was on track. But last month Defense Secretary Leon Panetta announced it would be abandoned in February in favor of a less costly plan to make DoD and VA systems “interoperable.”
The original e-records project, first implemented in 2004, was designed to streamline health care for military personnel transitioning to civilian life. It was slated to go into effect by 2017 at a cost of about $4 billion, according to DoD estimates from last year. But this year, officials scrapped that plan when technology challenges persisted and cost estimates nearly doubled, opting instead to build a system based on existing programs.
The “patchwork of initiatives” that has been put in place over 15 years leaves veterans shortchanged by an outdated system, said Valerie Melvin of the Government Accountability Office, Congress’ investigative arm.
Melvin authored a report that questioned the departments’ ability to share health records with existing systems.
“This is the result of poor oversight and inadequate accountability,” she said.
Elizabeth McGrath, DoD’s deputy chief management officer, said the new scaled-back program will be in effect by the end of this year, saving the government “hundreds of millions” of dollars, although she did not provide specific cost figures.
Viterna was pessimistic about the prospects of the plan.
“The track record makes you suspicious of how effective it can be,” he said. “It’s a shame.”
While the VA has used an electronic health record system called VistA for decades, DoD leaders said they are still evaluating possible e-record options to replace their current system, called Ahlta.
“As long as the VA and DoD remain in separate camps, pursuing their own individual systems, it’s the veterans that will be short-changed,” said Jacob Gadd, deputy director for health care at the American Legion and a former Navy hospital corpsman.
But the failure of decade-long efforts to streamline medical record-keeping for service members has many lawmakers skeptical about the prospects of the latest attempt.
At a House Veterans Affairs Committee hearing in February, lawmakers blasted officials for dumping a program that has already cost the government an estimated $1 billion. Rep. Jeff Miller, R-Fla., chairman of the House committee, lambasted DoD and VA officials for “down-the-drain funding” to programs that have shown few results.
“I’m concerned we’re taking a step back toward a model that has been tried and failed,” Miller said.
Miller voiced concern that VA and Defense Department officials focused too closely on cost-cutting measures.
“It sounds like we’re talking too much about finding the least expensive solution, and not the solution that’s best for our veterans,” he said.
Rep. Jeff Denham, R-Calif., called the situation “inexcusable.”
“In the private sector, this would be done by now — it would have to be,” he said. “I don’t feel the same sense of obligation here. I question the will to get it done.”
With sequestration knifing into federal budgets, McGrath said the Pentagon doesn’t yet “fully understand the impact that sequestration could have” on the electronic medical record program. Adding to complications is the return of about 34,000 service members over the next 12 months. With about 45 percent of Iraq and Afghanistan veterans seeking disability compensation for injuries—a “historical high,” according to the VA—even more pressure is expected to be added to an already back-logged system.
“I don’t see anything here that makes me think we won’t be sitting here in another 10 years asking the same questions and having the same problems,” said Rep. Phil Roe, R-Tenn.