Hospitalists & the Veterans Health Administration
If you are a hospitalist working for Kaiser, IPC, or another of the large healthcare systems, you may wonder what the Veterans Health Administration Healthcare System (VA) could possibly have to do with your practice. In many ways, the VA is the prototype, risk-adjusted, capitated accountable care organization (ACO) focused on expanding access to affordable healthcare, lowering costs, and improving quality. We care for complex, diverse, often vulnerable patient populations. We are incented to keep them healthy and out of the hospital. As a highly integrated healthcare system with 152 medical centers and more than 400 hospitalists, the VA has been able to coordinate hospital care, primary care, and post-acute care in a way that many health systems hope to achieve.
VA hospitalists care for veterans with multiple issues, including acute MI, heart failure, pneumonia, and COPD. In short, we care for the same types of patients as hospitalists across the country, with measured outcomes of similar or better quality as non-VA patients.
The VA has utilized an advanced electronic health record (CPRS) since 1997. It allows for effective patient care and is successfully leveraged for large-scale health services research.
The VA has been the site of groundbreaking, Nobel Prize-winning research that has shaped the care of hospitalized patients worldwide: beta blockers for heart failure, steroids for COPD exacerbations, and the invention of implantable cardiac pacemakers and computerized axial tomography (CAT) scans all have as their foundation research performed at VAs.
VA hospitalists educate the next generation of physicians through robust academic affiliations with most of our nation’s most-renowned medical schools and have administered residency training programs for almost 60 years. More than half of all medical students and residents complete part of their training at VAs.
VA hospitalists are also leaders in quality and patient safety.
Over the next year, SHM’s VA Task Force will be sharing 10 of the innovative approaches VA hospitalists are taking to provide care for our nation’s heroes. We will dispel a few myths about the “VA Spa” along the way and, hopefully, share some ideas you can use to better care for your patients.
Many of The Hospitalist’s readers have family members who have served in the military. For all of you, this IS your granddad’s VA—and it’s pretty darn good.
Dr. Odden is a hospitalist at the VA in Ann Arbor, Mich. Dr. Kartha is a hospitalist at the VA in Boston. Both are members of SHM’s VA Task Force.
