VA Gathers Winning Web Apps From Employees

The Veterans Health Administration/Office of Information Technology (VHA/OIT) held an Innovation Competition in which VA employees submitted ideas for improving veterans' healthcare with new or improved information technology. From the project, 26 ideas have been awarded funding for prototype testing and possible initiation within the VA's healthcare system.

With Web-enabled technologies moving to the fore in healthcare, the VHA is working to improve patient care through not only internal IT improvements, but also via patient-centered Internet technology.

Secretary of Veterans Affairs Eric K. Shinseki said in a statement, "The employees who participated in this competition exhibited tremendous creativity and out-of-the-box thinking. Their ideas will help the department improve health care quality, access, and transparency in service to our nation's Veterans."

Of the 6,500 entries submitted, online voting (among VA employees) narrowed the list down, and a panel of healthcare and IT leaders then finalized the 26 winners. Of those ideas, two are Web-centric and the rest are mostly internal changes designed to improve work flow and patient care within the VA's current IT systems.

Since some suggestions pertain to existing systems, for someone who isn't part of the VHA or in the medical field, it may be hard to understand some of the ideas. So healthcare provider and veteran (US Navy) Katherine Sutherland of Cheyenne, Wyo., stepped in to help explain some of them. Katherine is a certified nursing assistant (CNA), has a degree in medical assisting, and works in the private sector.

Of the 26 key ideas bulleted in the VHA/OIT press statement, the Internet-based solutions include a more robust VA forms search engine and the ability for patients to track mailed prescription delivery. Other items that Sutherland noted as being of interest included internal records-handling and patient-centric solutions:

Table 1: The VHA/OIT Innovation Competition Winning Innovations

From the patient's perspective, says Sutherland, "the VA forms search engine is a great idea. Anyone who's dealt with government knows that there are a lot of forms and getting the right one is not always easy." Currently, forms are accessible online, but if you don't know the form number or the specific title of the form, you won't easily find it.

Sutherland is also impressed with the idea of "parking" outpatient medications to prevent waste (pharmacies often hold prescriptions for a set amount of time, then throw them out) and with the idea of illustrated medication instructions. The VA didn't specify whether Rx "parking" would be done with the ability to see a prescription's status online, but it would make sense.

"Illustrations would probably reduce the amount of confusion," Sutherland continues. "While veterans aren't stupid, of course, many are enfeebled and old and some have poor short-term memories because of their illnesses. Illustrated cards or foldouts would make it easier for veterans, their spouses, or their in-home caregivers to ensure they are getting the right dosages at the right times."

Sutherland is also impressed with the idea of mail tracking for postal deliveries of prescriptions, but when asked about costs, she said this would likely raise the cost to the VA. Currently, the agency mails prescriptions through the US Postal Service using delivery confirmation, but without tracking. The USPS does not offer tracking services and UPS or FedEx would cost significantly more. "So this may not work," she admits, "unless they just plan to allow patients to look online to see if their prescription has been sent or delivered -- which you can already do over the phone."

Sutherland's favorite improvement is something that would help internally to reduce costs and redundancy in the VA. "The informatics [improvements] would be great if they're presented across-board with the patient's various providers (doctor, pharmacy, nurses, etc.) as this greatly improves the interaction between patient and provider and reduces the amount of tedious Q&A that often takes up a lot of each visit, as the information would already be available."

Since the suggestions for the VHA/OIT contest were from employees in the VA's system, the ideas would seem more likely to be beneficial than were they taken willy-nilly from the public at large. This has been a lesson learned from the recent surge in government applications of all types, which have lead cities like Washington to rethink their public-sector technology (technology produced by the public to make it easier to use publicly available data). D.C. is now cutting back their Apps for Democracy program in order to push for more useful and less flashy applications from participants.

However the ideas are garnered, if they improve healthcare for our nation's veterans, they’re a good thing.

— Craig Agranoff is an entrepreneur and national social media consultant as well as a published specialist in online reputation management and monitoring.