The VA may have only 1200 patients per doc versus 2,000 in the general population, but I suspect, having seen many elderly VA patients as a state certified Medicare counselor in Maine, that this population is significantly less healthy than the population as a whole. So not apples to apples. I also suspect most government IT systems are old and difficult to maintain. It is a concerning and chronic issue that will require dollars to solve.
Great analysis Dave. Another issue to dig into at the VA is recruitment and retention of medical staff. How many of the current staff are FMGs? In my experience some foreign trained doctors who don’t qualify for medical staff status at U.S. Hospitals may be employed by the VA. Granted that many of these docs may be highly qualified but who knows. Your point about getting comparative data for evaluating quality metrics like infection control, medical errors, and other “ never events” would be useful. However, I suspect that cost control is now a much higher priority than access and quality.
You probably saw the recent news that the IRS modernization project was $15 billion over budget and 30 years behind. The VA has a similar problem with the Cerner implementation. It’s a 10 year contract that they’re seven years into and have implemented only a handful of hospitals with only a few more projected in the next couple of years. It’s a huge problem.
The VA may have only 1200 patients per doc versus 2,000 in the general population, but I suspect, having seen many elderly VA patients as a state certified Medicare counselor in Maine, that this population is significantly less healthy than the population as a whole. So not apples to apples. I also suspect most government IT systems are old and difficult to maintain. It is a concerning and chronic issue that will require dollars to solve.
Great analysis Dave. Another issue to dig into at the VA is recruitment and retention of medical staff. How many of the current staff are FMGs? In my experience some foreign trained doctors who don’t qualify for medical staff status at U.S. Hospitals may be employed by the VA. Granted that many of these docs may be highly qualified but who knows. Your point about getting comparative data for evaluating quality metrics like infection control, medical errors, and other “ never events” would be useful. However, I suspect that cost control is now a much higher priority than access and quality.
You probably saw the recent news that the IRS modernization project was $15 billion over budget and 30 years behind. The VA has a similar problem with the Cerner implementation. It’s a 10 year contract that they’re seven years into and have implemented only a handful of hospitals with only a few more projected in the next couple of years. It’s a huge problem.