- The Washington Times - Friday, September 28, 2007

ANALYSIS/OPINION:

After 25 years of congressional pressure and a half-dozen conflicts, our wounded should not sense any interruption transitioning between the military and VA’s medical system. In reality they do.

In 2006, I watched severely wounded soldiers arrive at the Army’s Landstuhl Regional Medical Center in Germany from Balad, Iraq, their paper medical records taped to their chests.

One of our biggest challenges is the transition between military treatment facilities and VA, and managing sub-acute and follow-on care, such as rehabilitation. If a soldier’s paper-based records are incomplete — as VA doctors tell us they frequently are — treatment and recovery may suffer as VA doctors wait for the military to send key documents.

Since the beginning of Operation Enduring Freedom, we have developed new tactics, fielded new weapons systems and ushered in new governments. Yet, while the VA has developed a state-of-the-art electronic medical record system, the Department of Defense has not fully cooperated in developing a bi-directional, interoperable exchange of medical data that can enhance recoveries and save lives.

Some background: Congress codified the concept of “DoD/VA Sharing,” now called “seamless transition,” in the 1982 Veterans Administration and the Department of Defense Health Resources Sharing and Emergency Operations Act, which became public law 97-174. The law created the VA-Care Committee to supervise and manage opportunities to share medical resources.

While I was a subcommittee and committee chairman in the House Committee on Veterans’ Affairs, between 2000 and 2006, we held 19 hearings on seamless transition. Another subcommittee hearing was held this year on the problems servicemembers are having with transition.

Bipartisanship between the House Veterans’ Affairs and Armed Services committees is showing results. The National Defense Authorization Act for fiscal 2008, which the House passed, includes seamless transition provisions similar to an amendment I developed for the Wounded Warriors Assistance Act of 2007.

When I met with Sen. Bob Dole and former Health and Human Services Secretary Donna Shalala at the onset of their commission’s inquiry in March, I told them to pick a few big topics and go deep. I asked them to be soldier-centric. The use of complementary systems to ease the servicemember’s burden is a unifying theme in their report. Mirroring one of the act’s provisions, they recommend real-time, interoperable, and bi-directional transfer of critical medical information on wounded servicemembers from DoD medical facilities to the VA.

If we are truly going to be soldier-centric, we must find and use the best care our nation can provide — the closer to the warrior’s home and family, the better. If we have the required health-care services in the military or the VA, we should use them; if not, we should contract for them. To do anything less is to place the system’s demands over the patient’s well-being. Seamlessness does not end upon discharge from a DoD or VA hospital. Disabilities can emerge years later. Conditions are often aggravated with age; early identification of disabilities and conditions that may cause them is critically important in aiding the seamless transition of the new veteran. Instead, the servicemember is given a military separation physical and then a VA physical to determine eligibility for disability benefits. This inefficient process impedes effective health care, benefits delivery and quality of life for servicemembers and their families.

Our provisions in the NDAA also require use of a uniform separation and evaluation physical by DoD and VA that VA could use for disability rating, co-location of VA benefit teams at military treatment facilities and other sites, and use of an electronic DD-214 to speed the benefits process.

Timely and accurate claims decisions are integral to the quality of a servicemember’s transition into civilian life, yet the system produces long waiting times and too many flawed, inconsistent decisions.

Procurement reform falls under that theme, and is the next frontier between DoD and VA in particular, compatible medical equipment. We intend that information technology be seamless and bi-directional; the same should apply to compatible and interoperable medical equipment.

The military and the VA must accelerate their efforts to integrate their electronic medical records so that veterans can transfer from one agency to the other quickly, without encountering lapses in treatment. We must as a government get off our heels and onto our toes.

Our men and women in uniform should not have to wait another 25 years.

Rep. Steve Buyer, Indiana Republican, is the ranking member of the House Committee on Veterans’ Affairs.

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