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VA New England Healthcare System

 

Fact Sheet - Improving Care for Veterans in the Greater Boston Area

January 2014

Summary:

VA New England Healthcare System has received approval to improve care for Veterans in the Greater Boston Area by taking multiple steps to address difficulties encountered by Veterans, families and staff of VA Boston Healthcare System (HCS) and Bedford VA Medical Center (VAMC). These medical centers serve the same geographical area and Bedford is dependent on Boston for many clinical services.  Two separate VA healthcare systems in the same geographical area have created barriers to the coordination of Veteran care, access, and regional planning.  These barriers include:

  • Separate medical record which leads to duplication of prescriptions, testing, and consultations
  • Separate scheduling systems leading to conflicting appointments
  • Transportation systems not coordinated
  • Limitations on ability to access services across systems
  • Lack of regional planning

 Statement (Response to Query (RTQ)):

VA New England Healthcare System, Veterans Integrated Service Network (VISN 1) has announced an initiative to improve care for Veterans in the Greater Boston Area who are currently being served by two overlapping VA health care systems.  This initiative will lead to enhanced coordination of care, administrative efficiency, and improved regional service.

VISN 1 currently has two healthcare systems serving the Greater Boston area: VA Boston Healthcare System (HCS) and the Edith Nourse Rogers Memorial Veterans Hospital (Bedford VAMC).  These medical centers serve essentially the same geographical area and Bedford is dependent on Boston for many clinical services. 

Key Facts:

  • This initiative will lead to increased coordination, collaboration and Veteran satisfaction. Bedford VAMC would also remain as a distinct and independent medical center.
  • Over the past two decades, VHA has been moving from a system of independent hospitals focused on providing acute care to health care systems providing comprehensive services to regional populations. The unification of some systems and increasing coordination between the two medical centers supports this shift. This approach also leads to improved coordination of patient care by reducing the need for patients to navigate disparate healthcare systems in order to receive the full range of needed care.
  • The path to increased coordination and unifying systems includes:
    •  Combining the electronic medical record – The major driver for change is the existence of two separate medical record systems for shared patients. Both systems will shift to using a single record, an approach which is widely used in VA during CBOC and medical center realignments.
    • Unifying appointment systems – Currently Bedford VAMC and VA Boston HCS have separate patient appointment systems. Staff at each facility must lookup information from another web-based system, that is time consuming and they must be made aware that the patient is in the other system. This web based lookup is an excellent tool for patients who occasionally travel to different areas, but is unacceptable for routine care.
    • Increased sharing of medical staff – Alliances with medical staffs will increase coordination, collaboration and greatly contribute to a single standard of care. This will allow for enhanced quality and breadth of specialty services offered at Bedford VAMC. It will also result in fewer handoffs and enhanced information flow for patient safety.
    • Better coordination of transportation systems – Shared governance and more extensive regional planning will enable better coordination of transportation systems. Coordination will include the greater needs of the Veteran population and will yield operation efficiencies.
    • Enhanced regional planning – The strength of the VA system is strategic planning to coordinate services and ensure access to care across geographical areas.
    • Expanded use of regional services - VA New England Healthcare System within the Boston area already utilizes regional programs that are cost efficient and ensure a single standard of care. Examples include Clinical Engineering, Health Informatics, Laundry and Food Preparation. Use of these types of regional services will expand and result in greater operational efficiencies and better use of limited resources.
  • Bedford VAMC will continue as a distinct and independent VA Medical Center
  • Many opportunities for further growth of VHA services exist in the greater Boston area, including continued expansion of research and teaching activities, enhanced homeless programs, and further development of rehabilitation and long term care programs for special populations, such as SCI and TBI. Unifying systems and increased collaboration will contribute to ensuring such growth occurs in a value added, coordinated way.
  • VA New England Healthcare System will continue to adapt to the ever-changing needs of its Veteran population. While unifying systems and increased coordination will be invisible to the Veterans, they will notice enhanced service availability.