VA budget would boost health IT, claims processing

A significant amount of the IT money would go toward implementing an enhanced version of VA's electronic clinical health record system.

Information technology is critical to the timely delivery of benefits and services to veterans, so President Bush’s fiscal 2009 budget request would increase Veterans Affairs Department IT programs by 19 percent over this year, Secretary James Peake said Feb. 4. A chunk of the IT spending would go for implementing an enhanced version of the department's electronic clinical health record system. “It is vital that VA receives a significant infusion of new resources to implement new systems and upgrades to existing systems, which have a direct impact on the medical care of veterans, the quality and safety of that care, and the underpinning IT infrastructure that makes health care delivery possible,” Peake said in announcing the VA's  budget. Under the president’s budget, VA would receive $93.7 billion for 2009, $3.4 billion more than current spending, Health care and disability payments and processing would get most of the funding. Of the total budget, $47.2 billion is for discretionary funding, mostly for health care, and $46.4 billion is mandatory for other VA benefits for education, home loans and compensation. In 2009, VA would intensify its collaboration with the Defense Department to provide high-quality health care and benefits to veterans, service members and their families, including progress toward the development of interoperable and secure electronic health records that can be used by both departments. The budget would also support implementing the recommendations of the President’s Commission on Care for America’s Returning Wounded Warriors, or the Dole-Shalala Commission, led by former Sen. Robert Dole (R-Kan.) and Donna Shalala, Health and Human Services Department secretary in the Clinton administration.President Bush created the commission after bureaucratic and administrative roadblocks to proper care for wounded soldiers at Walter Reed were revealed last year. The recommendations focus on soldiers returning from Iraq and Afghanistan. The budget would support VA’s efforts to reduce its disability claims backlog, which could reach 872,000 claims awaiting resolution in 2009, by acquiring greater access to DOD’s online medical information, reducing VA’s reliance on paper-based claims folders and hiring new staff. By the beginning of 2009, VA expects to have hired 3,100 new staff members, Peake said. Resources requested also would allow VA to improve the timeliness of claims processing to 145 days, a 21 percent improvement over 2007. The number of claims processed will grow to 940,000, 14 percent more than in 2007, the agency said. VA and DOD in 2009 are scheduled to complete a pilot program of a new disability evaluation system for wounded soldiers at major medical facilities in the Washington, D.C., area. The program aims to eliminate duplicative elements of the disability processes used by the departments. The pilot program is to include one medical exam performed under VA protocols and a single disability rating that VA determines. The president’s budget devotes $252 million for research on traumatic brain injury, poly-trauma, spinal cord injury, prosthetics, burn injury, pain and post-deployment mental health, Peake said. VA’s IT program would receive $2.4 billion, $389 million more than this year. That figure reflects the realignment of all IT operations and functions under the control of the chief information officer, Peake said. The proposal also contains $93 million for cybersecurity programs. “The IT consolidation has given VA the opportunity to look at all aspects of the state of VA IT and…support efforts to provide improved, standardized IT services, leading to consistency and dependability across the department,” Peake said.The budget would provide $284 million for development and implementation of VA’s modernized electronic health record, the Veterans Health Information Systems a nd Technology Architecture program. VA's budget also includes a health data repository, a patient scheduling system and a re-engineered pharmacy application. For financial management, the budget would target $45.1 million for the Financial and Logistics Integrated Technology Enterprise system, now in its planning phase, to replace the legacy financial system and program. VA would seek $23.8 million to complete the transition of compensation and pension payment processing to VETSNet, which would improve claims processing efficiency and accuracy, payment integrity and fraud prevention in addition to supporting the department’s Paperless Claim Processing Initiative, the department said. VETSNet, the Veterans Service Network, is a suite of applications that provide benefit payment and accounting functions in addition to information and workflow management across the compensation and pension claims process.