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VA’s Draft Legislation Seeks to Expand Criteria for Choice Program

By Sandra Basu WASHINGTON—The VA has sent draft legislation to Congress that would revamp criteria for outside care, including eliminating the controversial “30-day/40-mile” rule. “We want veterans to work with their VA physicians to make... View Article

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Draft Bill Calls for ‘BRAC’-like Commission on VA’s Outdated Infrastructure

By Sandra Basu WASHINGTON—Draft congressional legislation is calling for a commission to make recommendations regarding VA’s infrastructure. Even supporters admit the “deck is stacked against” it. In introducing the bill, which potentially could lead to... View Article

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Device Developers ‘Kicked a Hornet’s Nest’ in Hemorrhage and Shock Treatment

For Air Force Col. Todd Rasmussen, MD, and Jonathan Eliason, MD, the idea for a new way to treat internal hemorrhaging on the battlefield was hard-won.

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Severe Side Effects Rare in Elderly Veterans Receiving High Dose Influenza Vaccine

Patients over the age of 65 face an increased risk of severe complications and death if they contract influenza.

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Funding Extends Veterans Choice Program for Another Six Months

By Sandra Basu WASHINGTON—Calling it another “tangible improvement” for veterans, VA Secretary David Shulkin, MD, lauded the VA Choice and Quality Employment Act of 2017, which was signed into law last month. The law authorizes... View Article

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Law Requires Reconsideration of Mustard Gas Claims by WWII Veterans

By Sandra Basu WASHINGTON—President Donald Trump signed a bill directing VA and DoD to reconsider and make new determinations for all previously denied claims for benefits related to exposure to mustard gas or lewisite, a... View Article

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VA Makes Public List of Adverse Actions Against Employees

With persistent questions of accountability and transparency dogging VA in recent years, the agency became the first federal agency to post public information on disciplinary actions taken against employees.

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VA Seeks to Fill Graduate Medical Education Positions in Next Seven Years

By Sandra Basu WASHINGTON—VA officials told lawmakers that they anticipate filling, by 2024, all of the graduate medical education (GME) positions authorized in a 2014 law. “We believe within the 10-year milestone we will be... View Article

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VA Antimicrobial Stewardship Helps with UTIs

BUFFALO, NY—Implementation of an antimicrobial stewardship program (ASP) appeared to significantly decrease duration of antibiotic therapy and length of hospitalization for complicated urinary tract infection at the Buffalo, NY, VAMC, without adversely affecting 30-day readmission... View Article

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Navy Functional Restoration Pain Program Shows Success

Chronic pain is the leading cause of medical discharge from active duty military service. Disability payments related to the condition also are a significant economic cost to the DoD.

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Spinal Manipulation Modestly Effective for Low-Back Pain

Spinal manipulative therapy (SMT) is a treatment option for acute low-back pain, but randomized clinical trials (RCTs) and meta-analyses have reported different conclusions about its effectiveness, according to a new study.

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Veterans Choice Program Increases Burden on VA Pharmacists

The Veterans Access, Choice and Accountability Act in 2014 allows veterans to receive covered care and prescriptions from non-VA providers in a variety of situations.

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VA’s Fails to Follow Own Requirements for New Hire Drug Testing

WASHINGTON — VA is “committed to 100% testing of all final selectees” for its safety-sensitive occupations prior to their appointment, lawmakers were told recently.

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Opioid Use Generally Moderate in OEF, OIF, OND Veterans

LITTLE ROCK, AR — With continuing concern about opioid use in veterans, especially those serving in Afghanistan (OEF) and Iraq (OIF and OND), a new study provided a detailed analysis of the issue.

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VA Might Yet Move to Commercial EHR System

After years of working to modernize its electronic health record internally, a senior IT official indicated last month that a shift to a commercial EHR is the likely path forward for VA.

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Brachytherapy Usage Decreases in Prostate Cancer

While several prior studies have suggested that brachytherapy utilization has significantly decreased as intensity modulated radiation therapy usage has increased, a group of VA researchers sought to investigate brachytherapy utilization in a large, hospital-based registry.

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Metformin Improves Colorectal Cancer Survival in Veterans

Metformin has been associated with improved colorectal cancer survival (CRC), but investigations have been limited by small numbers of patients and confounding by diabetic severity, according to a new study.

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Don’t Forget Leishmaniasis When Servicemembers Have Mysterious Symptoms

Military physicians stumped by a diagnosis might want to consider leishmaniasis in personnel returning from Iraq or Afghanistan, according to a new report.

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Appointment Delays Continue at VA’s Phoenix Healthcare System

Two years after the Phoenix Healthcare System came under fire for delayed patient care and wait lists, a recent VA Inspector General’s (IG) report has found that patients continue to encounter delays in care at the hospital.

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VA Offers Pharmacy Staff Free Diabetes Management Certificate Course

A free online certificate course on diabetes made available at the VA and DoD earlier this year already has had more than 550 enrollments and awarded 15 certificates.

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Types of Skin Lesions Referred by PCPs at VA

MINNEAPOLIS—Skin lesions sent to dermatology by primary care physicians (PCPs) represent a significant proportion of VA healthcare visits, according to a new study.

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VHA Costs to Treat Keratinocyte Carcinoma

Keratinocyte carcinoma (KC) is by far the most common cancer in the United States, with basal cell and squamous cell carcinomas accounting for about 80% and 20% of cases of KC, respectively.

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Surgical Wait Times Decrease at VAMC After ‘Lean’ Process Implementation

While automobiles and patient health might seem to involve very different processes, what Japanese car maker Toyota achieved in quality improvement in the 1980s has intrigued hospitals for decades.

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Wider Use of Biosimilars Promise Significant Savings for VA

Even as biologics offer new options for patients suffering from a wide range of diseases today, their steep prices pose a significant challenge to healthcare system budgets.

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White House, VA Oppose Oversight From Independent Board

Transforming the VHA does not require an independent board of directors overseeing the healthcare system, as recommended in a recent report, according to VA Secretary Robert McDonald.

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VA Pushes for Presumptive Coverage for Camp Lejeune Veterans

Under a newly-proposed regulation, thousands of veterans could have an easier time obtaining disability benefits for certain conditions linked to service at Camp Lejeune.

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VA Explores Pain Management Alternatives to Delay Opioid Use

By Annette M. Boyle WASHINGTON—Since the rollout of the VA’s Opioid Safety Initiative in 2014, the department has aggressively focused on developing non-narcotic alternatives to reduce opioid use for chronic pain. Now, attention is turning... View Article

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VA Healthcare Workers Have Relatively Low Flu Vaccine Rates

ANN ARBOR, MI—Multiple national recommendations encourage all healthcare workers to get the influenza vaccination, thereby reducing the chance they will pass the virus on to their patients. Despite a patient population of older and sicker... View Article

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GAO: VA, DoD ‘Years Away’ From EHR Interoperability

By Sandra BasuWASHINGTON—A modernized VA electronic health record system that is fully interoperable with DoD’s system “is still years away,” according to the Government Accountability Office (GAO).“Uncertainty and important questions remain about what the department... View Article

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Commission Report Calls for Overhaul of VHA Structure

Panel Suggests Most Care Be Community-BasedBy Sandra BasuWASHINGTON—Calling the Veterans Choice Program “flawed,” a key report puts forward an alternate framework for VA to broaden provider options: an “integrated, community-based health care network” in what... View Article

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Inappropriately Shredded Claims: VA Internal Debate on Significance

 By Sandra BasuWASHINGTON—How widespread is the problem of improper shredding or otherwise mishandling paper claims from veterans, and is the Veterans Benefits Administration (VBA) doing enough to resolve the situation?That was the topic of a... View Article

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Many Dementia Patients Have Multiple Brain Ailments

HONOLULU— New VA research offers persuasive evidence that dementia commonly results from a combination of brain ailments, rather than from a single condition, even if an Alzheimer’s diagnosis has been made.That information is based on... View Article

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Turning the Tide on Rising VA Hepatocellular Carcinoma Rates

HOUSTON — After a decade of dramatically rising rates of hepatocellular carcinoma (HCC) among veterans, aggressive treatment of hepatitis C infections (HCV) appears poised to turn the tide.

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Tampa Rehab Director Oversaw Polytrauma Care Development

TAMPA, FL — It was the churches and sidewalks that did it. The James Haley VAMC in Tampa used them to coax Steven Scott, DO, the center’s current chief of physical medicine and rehabilitation, away from his position at the Mayo Clinic in 1990.

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Proposal to Phase Out VA Healthcare Upsets Veteran Groups

A controversial proposal to give all current VA-enrolled veterans the option of community care and to transition the rest of veterans to private market healthcare during the next two decades is making veteran service organizations (VSO) and others uneasy.

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Older Veterans Must Weigh Benefits of ‘Expectant Management’ in Prostate Cancer

By Stephen SpotswoodATLANTA — For patients diagnosed with a malignancy, the natural response is to ask the physician to do everything possible to treat the cancer.The challenge for VA clinicians and others, especially with older... View Article

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IOM: VA Should Focus on Gulf War Syndrome Treatment, Not Causes

Veterans Groups Warn That Research Could EndBy Annette M. BoyleWASHINGTON — A major scientific panel has recommended that the VA stop looking for the cause of Gulf War illness and focus instead on monitoring deployed... View Article

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CAD Linked to Macular Degeneration in Veterans

LEXINGTON, KY — VA clinicians should co-screen for age-related macular degeneration (AMD) and systemic vascular disease, according to a new study.The report, published recently in the Southern Medical Journal, notes that, although AMD — the... View Article

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VA Care for Common Conditions Compares Favorably With Medicare Hospitals

Patients treated at the VA had a lower 30-day all-cause mortality rate for heart attack and heart failure than those treated at other hospitals, according to a new study.

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RAND Reports Find No Evidence of Widespread Extended Wait Times at VA

One of the most-common complaints about VA healthcare is that veterans have to wait an inordinate amount of time for a medical appointment. A new congressionally-mandated review reveals that isn’t true in most cases.

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GAO Report Urges Clarification on VHA, DoD Drug Transition Policy

Last year, a new policy instructed VHA providers not to discontinue mental health medications initiated by DoD providers due to formulary differences.

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Comorbid Mental Disorders Increase VHA Diabetes Costs

CHARLESTON, SC — Costs of treating diabetes increase when patients also have mental health issues, according to a new VHA study.The study, which was published recently in the American Journal of Managed Care, looked at... View Article

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VA CABG Patients Increasingly Older, Sicker

Over a 14-year period, VA patients undergoing coronary artery bypass grafting (CABG) were progressively older and sicker, with an increasing prevalence of obesity, diabetes, left main coronary artery disease and advanced heart failure, according to a new study.

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Healthcare Advocates Argue for More Unified Military Medical Command

By Sandra BasuWASHINGTON — Healthcare advocates weighed in on the controversy over governance of military medicine, arguing for a unified command in which all the medical assets of the three services are under a single... View Article

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Cirrhosis Expected to Peak by 2021 in VA; Liver Cancer Epidemic Continues

For the VA, the combination of effective treatment options and much lower prevalence of HCV in younger veterans may offer a light at the end of the tunnel — and a turning point in the steady rise of HCV-associated complications such as cirrhosis and hepatocellular carcinoma (HCC) in only a few years.

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DoD, VA Scolded Again for EHR Interoperability Delays

By Sandra BasuWASHINGTON — DoD informed Congress last month that it has met key interoperability requirements set forth in the 2014 National Defense Authorization Act.DoD Undersecretary of Defense for Acquisition, Technology and Logistics Frank Kendell... View Article

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Recommendations to Improve Governance at VA

Establish a governance board to develop fundamental policy, define the strategic path, insulate VHA leadership from direct political interaction, and ensure accountability for the achievement of established performance measures. Congress should consider the following alternatives... View Article

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Electronic Triggers Speed up Follow-up for Cancer Diagnosis, Care at Houston VAMC

By Brenda L. MooneyHOUSTON — Over the last years, the VA has struggled with ways to reduce follow-up delays for patients, such as those being evaluated for cancer.Researchers at the Michael E. DeBakey VAMC and... View Article

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VA Leads Nation in Using Big Data to Improve Healthcare

Developers Caution Against Too Much of a Good ThingBy Annette M. BoyleSEATTLE — Now that nearly every hospital in the United States uses electronic health records, healthcare systems across the country are wrestling with how... View Article

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Veterans Choice Program Eases Process Somewhat for Outside Prescriptions

By Annette M. BoyleWASHINGTON — Veterans who receive care through the Veterans Choice Program may not have many choices when it comes to prescriptions from those outside providers, but they do have more than those... View Article