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The Honolulu Advertiser
Posted on: Monday, August 28, 2006

A glitch in VA medical records?

By Tom Philpott

William Winkenwerder Jr., assistant secretary of defense for health affairs, took time during an Aug. 23 teleconference with journalists to tout his department's ability to transfer electronically the medical records of separating service members to the Department of Veterans Affairs.

But there is a rising chorus of critics who say AHLTA, the Department of Defense's digitalized medical record system, is a problem for the VA and for veterans because it does not allow electronic record transfers outside the military network.

The critics include the Government Accountability Office, senior VA officials and, most recently, the chairmen of both the House and Senate veterans affairs committees.

GAO reported last month that the biggest obstacle remaining for severely wounded troops to experience "seamless transition" from military care to VA trauma centers is the inability to transfer AHLTA records.

Sen. Larry Craig, R-Idaho, chairman of the Senate Veterans Affairs Committee, told Government Health IT that the VA has an "award-winning, highly touted" electronic health records system while the DoD "is still talking about 'requirements.' " This, Craig said, leaves him "to wonder whether DoD is just trying to justify ... building its own system."

Winkenwerder ignored these complaints and described how AHLTA's electronic data transfers are helping patients transition to VA healthcare.

"We transmit electronically every month records on our separated service members so that when (they) show up for services in the VA their records are available to providers, which is very important," Winkenwerder said. "Again, that is not something that existed a few years ago."

Winkenwerder praised AHLTA despite the GAO's findings that VA complaints regarding limits on electronic transfer of military medical records are well founded.

Through June, more than 19,000 service members had been wounded in Iraq and Afghanistan. Sixty-five percent had blast injuries, which often result in trauma requiring comprehensive rehabilitation. GAO said that nearly 200 severely wounded members, while still on active duty, have been transferred to VA poly-trauma centers for care and rehabilitation. Most of these cases involve brain injury, missing limbs and spinal cord injuries.

VA and DoD have strengthened procedures for transferring war-injured members and veterans, GAO said. Their joint programs have eased hassles for patients and families. VA social workers are assigned to large military treatment facilities to coordinate transfers. Military liaisons have been added to VA staff at poly-trauma centers to handle transition issues raised there.

But GAO said there are problems "electronically sharing the medical records VA needs to determine whether service members are medically stable enough to participate in vigorous rehabilitation activities."