VA and DoD Prepare for Integrated EHR in 2017 WASHINGTON—Defense Secretary Leon E. Panetta and VA Secretary Eric K. Shinseki reaffirmed that the agencies are on track to having an integrated electronic health record ready in 2017. In 2009 President Obama announced the Virtual Lifetime Electronic Record (VLER) initiative. According to the departments, a key component of that effort is the Integrated Electronic Health Record (iEHR), which will create a single, common health record for all DoD and VA medical facilities. Panetta said that a milestone in the effort will happen in 2014 when the departments roll out initial capabilities of the iEHR at test sites in San Antonio, Texas and Hampton Roads, VA. More
Army Announces PTSD Review WASHINGTON—The Army announced it will conduct a service-wide review of soldier behavioral health diagnoses and evaluations. Earlier this year, the Army announced that it was reviewing a number of behavioral health diagnoses at Madigan Army Medical Center after some soldiers had argued that their PTSD diagnoses were changed so that they would qualify for a lesser amount in disability compensation. That review is still ongoing, but the Army said it has already found that the original PTSD diagnoses were more accurate in some instances. The new review launched will examine diagnoses and evaluations made at all of the Army’s medical facilities. More
VA Releases Draft Plan on Women Veterans WASHINGTON—The VA is seeking public comment on a recently released draft strategy report that focuses on improving how it serves women veterans. The report was developed by VA’s Women Veterans Task Force which was charged with developing a comprehensive VA action plan in how the agency serves women veterans. The report states that while VA has made progress in serving women veterans, “work remains to be done.” More
Focus On: Men’s Health
New Medications, Technology Change VA's BPH Treatment GAINESVILLE, FL — Treatment of benign prostatic hyperplasia (BPH), the fourth most common diagnosis among VA patients over 50 years old, has changed radically in the last 15 years, with better management and medications making surgery a less-attractive option in most cases. The VA now recommends using “watchful waiting” for men who have mild BPH symptoms, but, once symptoms advance, treatment options multiply, as does the controversy surrounding them. More
Technology Offers Promise of Preventing, Repairing Genitourinary Injuries WASHINGTON—Since a report last year of the Army Dismounted Complex Blast Injury Task Force documented a sharp increase in the number of genitourinary (GU) injuries among U.S. warriors in Afghanistan, the DoD has taken several steps to better meet the healthcare needs of these fighters — but much remains to be done. To help prevent the injuries, Project Manager Soldier Protection and Individual Equipment (PM-SPIE) has been charged with coordinating research efforts focused on improving ballistic undergarments. The task force report noted that as much as 40% of pelvic and groin injuries may be mitigated by use of body armor. More
Focus On: PTSD
Virtual Reality Is No Game for PTSD Patients Reliving Traumatic Events ATLANTA — It might look like a game, but the virtual reality environment at Emory University has a very serious purpose: helping veterans with post-traumatic stress disorder (PTSD) move on from memories that have haunted them for months or years. Now, a new multicenter study will build on earlier work indicating the drug D-Cycloserine (DCS), originally approved to treat tuberculosis, enhances exposure therapy for PTSD. The other study centers are New York-Presbyterian/Cornell Weill in New York, Long Beach VA in California, Walter Reed Army Medical Center Bethesda campus and the National Intrepid Center of Excellence in Washington. More
Specialty Update: Obesity
VA-funded Study: Intervention Improves Diabetes Health Type 2 diabetes patients can improve their mobility significantly by participating in an intensive lifestyle program to both lower weight and improve fitness. That is according to a multicenter, randomized, controlled trial funded by the VA and other federal agencies. Data was available for just more than 5,000 patients with at least one follow-up visit, and those subjects demonstrated a 48% reduction in the risk for loss of mobility. More
Specialty Update: Prostate Cancer
Metformin/Statin Combination Lowers Prostate Cancer Risk The combination of metformin and statins appears to significantly reduce the risk of prostate cancer in veterans with type 2 diabetes, according to a recent study. In the study, researchers looked at data on 5,042 men with type 2 diabetes treated at the VA. In five-year follow-ups of the men, 7.5% of the patients had been diagnosed with prostate cancer. There was a significant correlation between use of metformin and lower prostate cancer incidence among patients on statins. More
Brenda L. Mooney Editorial Director, U.S. Medicine mooney@usmedicine.com 39 York Street Lambertville, NJ 08530
GAINESVILLE, FL — Treatment of benign prostatic hyperplasia (BPH), the fourth most common diagnosis among VA patients over 50 years old, has changed radically in the last 15 years, with better management and medications making surgery a less-attractive option in most cases. The VA now recommends using “watchful waiting” for men who have mild BPH symptoms, but, once symptoms advance, treatment options multiply, as does the controversy surrounding them. 
WASHINGTON—Since a report last year of the Army Dismounted Complex Blast Injury Task Force documented a sharp increase in the number of genitourinary (GU) injuries among U.S. warriors in Afghanistan, the DoD has taken several steps to better meet the healthcare needs of these fighters — but much remains to be done. To help prevent the injuries, Project Manager Soldier Protection and Individual Equipment (PM-SPIE) has been charged with coordinating research efforts focused on improving ballistic undergarments. The task force report noted that as much as 40% of pelvic and groin injuries may be mitigated by use of body armor. 
ATLANTA — It might look like a game, but the virtual reality environment at Emory University has a very serious purpose: helping veterans with post-traumatic stress disorder (PTSD) move on from memories that have haunted them for months or years. Now, a new multicenter study will build on earlier work indicating the drug D-Cycloserine (DCS), originally approved to treat tuberculosis, enhances exposure therapy for PTSD. The other study centers are New York-Presbyterian/Cornell Weill in New York, Long Beach VA in California, Walter Reed Army Medical Center Bethesda campus and the National Intrepid Center of Excellence in Washington. 