On Friday, Eric Shinseki, the Secretary of the Department of Veteran Affairs, arrived at the White House, and when he left 45 minutes later he was no longer employed.
This resignation comes after weeks of controversy and outrage around underperformance and coverups at the Veteran Health Administration. The New York Times has a good infographic on the panoply of issues which include data falsification, marathon wait times even for urgent medical issues, coverups, and manipulation of care to artificially improve indicators.
Shinseki's resignation may imply that the problems at the VA derive from this administration or even this individual. Unfortunately, that's far from the truth. As Jon Stewart insightfully detailed recently, these issues extend far past Shinseki's tenure, earlier than the Obama administration, and earlier in fact, than even the wars in Iraq and Afghanistan.
There is no excuse for the negligence that we, as a country, have demonstrated in caring for our Veterans. But politics aside, the difficult truth is that there are a number of intersecting issues that are creating the VA wait times and care backlog. On the supply side, there is a nationwide shortage of primary care physicians. And the veterans' demand for medical services is simultaneously soaring. As vets are more likely to live from catastrophic injuries, and with vets from Vietnam to Iraq to Afghanistan needing care, the number of outpatient visits to the VA has grown by 26% in the last 5 years (with medical staff growing by only 18%). Primary-care appointments have grown by 50%, while the department’s staff of primary care doctors has grown by only 9%. And across departments, doctors are supposed to be responsible for 1200 patients but are caring for 2000. (See article here.)
Of course, as the New York Times reports, "Republicans say the problem is not a lack of money — the department’s $154 billion annual budget has more than doubled since 2006 — but rather inefficiencies in the delivery of care. Democrats say that the problem is a serious shortage of doctors and not enough hospitals." Either way, the problems for the VA delivering timely and quality healthcare is related to medical providers being asked to do too much with too little (whether that lack is of time, support, or money). Which is something that all medical providers can surely empathize with.
So what are the VA and its committed medical providers to do? If anything, pressure is increasing for quick fixes to a problem that is constrained in large part by numbers of patients, number of doctors, and severity of medical issues. One fix that we see is to use telemedicine to leverage the time and energy of the providers that the VA has.
If the VA shortage of providers and resources resonates with you, these are some ways that telemedicine may be able to help:
- Telemedicine can drop readmissions and length of stay. Surprisingly, medical collaboration -- like that facilitated by telemedicine -- can improve numbers on both readmissions and length of stay.
- Telemedicine can save providers' time they're spent on care coordination. Most providers will tell you what this study proves: huge amounts of time are spent outside of patient care, coordinating care and waiting for patient data. Telemedicine, particularly hybrid store-and-forward telemedicine, can slash those wasted minutes and get you the data you need when you're ready to receive it.
- Telemedicine can loop in providers that are outside the system, but within a single patient visit. Of course, the most obvious use of telemedicine -- to enable consults with other providers even within a single visit -- is still a fantastic way to leverage provider time.
- Telemedicine can enable more providers to collaborate on complex cases, efficiently. Especially with the complexity of cases that the VA is seeing, multiple specialists and providers across the continuum of care are needed to care for a single patient. A medical collaboration platform will help you integrate all of these voices so that patients don't have to bounce from visit to visit with long wait times between each.
Looking for a telemedicine solution in your organization? We can help you sort through the options:
Image courtesy of dvids on Flickr, used under Creative Commons rights.