Wake up Veterans Affairs, before you die a death by 8.5 million paper cuts!

When one hears an opinion on the efficacy of the nation’s veterans health care system it is usually a discussion of components.

Right now mental health is the portion of the Department of Veterans Affairs medical system that is the “daily special” in terms of widespread interest due to media exposure and congressional oversight. A major sub-particle is that veterans are complaining that it takes too long to get mental health appointments. Growing numbers of young veterans with PTSD and traumatic brain injuries from national engagements in Iraq and Afghanistan make this a particularly topical subject.

There is no doubt that the VA — which sees about 6 million patients each year — is more than capable of what some medical experts have called “the best care available.” One may also forgive the VA, one of the government’s largest agencies, for tooting its own horn over its accomplishments

But like any large organization or bureaucracy the VA also faces its own undoing at times by what most would see as “the minor things” in the bigger picture. It is an expected flaw though treacherous when it comes to caring for a system with the total enrollment slightly more populous than New York City. In bureaucratic lingo, the VA must tackle the constant concern of “death by a million paper cuts.” Or, perhaps, let’s make that 8.5 million paper cuts, the aforementioned number enrolled for VA care.

Just today I was about to use the VA Web page for its patients, called “Myhealthevet.” Yes, that’s an “e” in there. I have now since forgotten what I was going to do on the site. But over the years that the site has been around it has grown in capabilities. Only, the growth has not been fast, nor on an even keel, and to be honest, it has frustrated the hell out of me.

Veterans who are enrolled in VA health care may join this site and have access to his or her prescription medicine information. Refills may be ordered from the site. This capability has been around for awhile. At times, one would only be given the prescription number and not the name of the drug. That isn’t particularly helpful say, you just happen to remember at work or while waiting to eat in a restaurant that your metformin needs to be refilled.

Likewise, the site has been unreliable when it comes to receiving medicines you ordered. I once ran out of meds after ordering them online and that is all it took for me to say, “No thanks.” As if an afterthought, a VA pharmacy person told me, “Oh yeah, don’t order them off the Web site.”

The ability to send secure e-mail to your medical professionals has in recent times been made available. One has to show up in person and see a video before opting in. Once through those “rigors” you may e-mail your medical team and perhaps even your doctor in some regional health systems. That is perhaps the most promising development out of the entire site, so far, at least. However, the real utility of secure messaging to communicate with your medical “team” comes from the fact that most VA hospitals and clinics I have encountered have massive difficulties with telephones.

Call the Michael E. DeBakey Veterans Medical Center in Houston. During the day, you will likely get a recording and can wait from here to yon until you get an operator. Then, the operator transfers you and the phone rings and rings and rings and rings. If you are lucky you will get a voice mail. If you are luckier you will get a voice mail that doesn’t say this voice mail is filled. Ordering prescriptions is the main reason I call the VA. I have learned to bypass all the “blah, blah, blah” and head strait to “Option 8” where you can hear recordings of your appointments or reorder prescriptions using your keypad by entering your Social Security Number and then the prescription number.

Great promise lies in the Web access to your medical needs. Veterans may download or view their entire medical record eventually. Well, not the notes where the doctor says you are a sociopath and don’t wash behind your ears. But otherwise, Myhealthevet has already shown its use. However, such a system fails miserably in reaching its potential when one needs to use it for something only to find it is shut down for maintenance. This has happened to me more times now than I am able to count.

The chaotic phone exercises, the Internet in a perpetual state of maintenance along with long waits for specialists or appointments help build from bottom up just where the VA medical system reaches a bundled package of failures. The system has its larger problems as well, money being the generically prevalent one. I speak of funding which may result in the socioeconomic triage where, sometimes, having insurance bodes well for those seeking better veterans health care.

This is not to say the VA health care system is bad and certainly I am not speaking ill of the employees in any general way. Rather, it is my personal wake-up call for an organization that performs miracles every day. I could go on. But all I am saying is that the VA should try harder at healing these millions of paper cuts. This system is all that is keeping many of us alive and healthy.



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