When the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act passed the House in March, it was expected to be a very hard sell in the Senate.
News
VA Pauses Further EHR Expansion Because of Patient Care Issues
The VA has paused any further expansion of its new electronic health record (EHR) in reaction to an early draft of a VA Office of the Inspector General (OIG) report.
Current Issue
VA Hospitalizations Dropped Moderately After Legislation Allowing Outside Care
With the implementation of the Veterans’ Choice Act of 2014 (VCA), hospitalization within the VA healthcare system showed a modest decline.
Arkansas VAMC Illuminates Bladder Cancer Using Blue Light Cystoscopy
Early-stage cancers can be very challenging to see, but finding them before they advance provides the best chance for curative treatment with the fewest complications.
COVID-19
COVID-19 Pandemic Reduced Prostate Cancer Biopsies Among VA Patients
The COVID-19 pandemic had a negative effect on prostate cancer screening and diagnosis rates among veterans, but no racial discrepancies were identified, according to a new study.
Veterans Study: Risk of Long COVID-19 Reduced Only Slightly by Vaccination
Despite vaccinations, improved treatments and generally milder symptoms associated with omicron and its subvariants, COVID-19 continues to be a major public health concern and source of uncertainty.
Pandemic Worsened Outcomes of Out-of-Hospital Cardiac Arrest
Outcomes of out-of-hospital cardiac arrest appears to have worsened, not only nationally but also at the state level, according to a new study focusing on Texas.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
A free people ought not only to be armed, but disciplined
Pam and I are visiting friends at their lake house on the Sam Rayburn Reservoir in Texas. As we were traveling, we were shocked at the slaughter of 19 children and two teachers at an elementary school in Uvalde, TX, on May 24. This hit particularly close to home, as our middle daughter is a second-grade teacher in Maryland.
New Legislation Gives VA Inspector General More Investigative Clout
Two pieces of new legislation would provide VA’s Office of the Inspector General with greater investigative power and employees with a better understanding of how OIG works and what their responsibilities are when asked for assistance by investigators.
VA Liquid Biopsy Study Aims to Screen 10,000 Veterans for Cancer
Veterans comprise nearly one-third of the participants in a major study evaluating a multi-cancer, early-detection blood test.
VA Makes Efforts to Respond to Healthcare Workers’ High Levels of Stress
As VA employees are reporting increasing levels of burnout, and the department is facing its highest turnover rate in decades, VA has tried to put systems in place to support staff mental and emotional health.
Concerns Raised Again About VA’s Widespread Cybersecurity Deficits
For the past four years, the annual Federal Information Security and Modernization Act (FISMA) audit has warned that the VA has lingering deficiencies across a wide range of cybersecurity areas, from agency wide security management programs to incident reporting and identity management.
Telemedicine Effective for Parenteral Chemotherapy Administration at VAMC
With patients in rural Nebraska who have trouble accessing the primary campus in Omaha, the VA Affairs Nebraska Western Iowa Health Care System (VA-NWIHCS) is using teleoncology and remote chemotherapy services to expand care to those veterans.
VA Tries to Address Societal Factors Leading to Veteran Suicides
For decades, VA’s response to preventing veteran suicide has been focused almost exclusively on healthcare, specifically mental healthcare.
Medications Might Skew Testing in One-Third of Older Vets With Hypothyroidism
Clinicians can find it difficult to manage hypothyroidism in older veterans, who tend to have a greater likelihood of adverse effects because of comorbidities, polypharmacy or both.
Veterans With CLL/SLL Have Suboptimal Adherence to New Therapies
Suboptimal adherence to new therapies for chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL), as well as related costs and healthcare resource use, demonstrate unmet needs in real-world treatment of the blood cancers, according to a new review.
Military/VA Search for New, Nonopioid Methods to Combat Chronic Pain
The last decade has seen health systems the world over shift away from using opioids for pain management. First there was the too-slow understanding that opioids are addictive and were being massively over-prescribed.
Depression Can Affect Dual-Task Walking in Multiple Sclerosis
Dual-task walking (DTW) can be a complex process for multiple sclerosis patients. A new study looks at what functions it requires.
Senate Changes Spread Out PACT Act Implementation Over Years
When the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act passed the House in March, it was expected to be a very hard sell in the Senate.
VA Pauses Further EHR Expansion Because of Patient Care Issues
The VA has paused any further expansion of its new electronic health record (EHR) in reaction to an early draft of a VA Office of the Inspector General (OIG) report.
VHA National Telestroke Program Uses Technology to Improves Acute Stroke Care
Prompt access to specialized care is critical to limiting the damage caused by a stroke.
VA Adds Nine Rare Cancers to Presumed Service-Connected Disabilities
Nine new rare respiratory cancers are now on the VA’s list of presumed service-connected disabilities for certain veterans exposed to fine particulate matter during military service.
Severe Staffing Shortages Continue to Plague VA Healthcare System
The VA healthcare system currently is grappling with about 50,000 vacancies, mostly among doctors, nurses, social workers and physician aides. In addition, the turnover rate among nurses is the highest the department has experienced since 2005.
Biden Underscores Commitment to Veterans Who Had Toxic Exposures
During the State of the Union address, President Joe Biden shined a light, as he has many times in the past, on the effects of toxic exposure, declaring that he would continue to make it a priority of his administration.
Is VA Doing Enough for Veteran Survivors Seeking Deserved Benefits?
Part of VA’s mission is to care for the widows and orphans of servicemembers and veterans, but some legislators have expressed concern that survivors are getting short shrift, especially when the veteran dies long after their initial service rather than in combat.
VA Announces Ambitious Plan to Improve Staff Recruitment, Retention
VA recently unveiled a 10-step human infrastructure plan designed to strengthen the department’s ability to recruit and retain staff.
Ann Arbor VAMC Rapidly Stands Up Monoclonal Antibody Treatment Service
As emergency departments around the country struggled to get through the day during the recurrent surges of the COVID-19 pandemic, the emergency medicine team at the LTC Charles S. Kettles VAMC here did something extraordinary—they sought out more patients to treat.
Omicron Variant Surge Causes Disruptions in VA, DoD Health Systems
The surge in COVID-19 cases created by the omicron variant has caused no small amount of chaos for federal healthcare agencies, resulting in the postponement of major projects, deployment of emergency medical staff and even the infection and subsequent quarantining of agency leaders.
A free people ought not only to be armed, but disciplined
Pam and I are visiting friends at their lake house on the Sam Rayburn Reservoir in Texas. As we were traveling, we were shocked at the slaughter of 19 children and two teachers at an elementary school in Uvalde, TX, on May 24. This hit particularly close to home, as our middle daughter is a second-grade teacher in Maryland.
New Legislation Gives VA Inspector General More Investigative Clout
Two pieces of new legislation would provide VA’s Office of the Inspector General with greater investigative power and employees with a better understanding of how OIG works and what their responsibilities are when asked for assistance by investigators.
VA Liquid Biopsy Study Aims to Screen 10,000 Veterans for Cancer
Veterans comprise nearly one-third of the participants in a major study evaluating a multi-cancer, early-detection blood test.
VA Makes Efforts to Respond to Healthcare Workers’ High Levels of Stress
As VA employees are reporting increasing levels of burnout, and the department is facing its highest turnover rate in decades, VA has tried to put systems in place to support staff mental and emotional health.
Concerns Raised Again About VA’s Widespread Cybersecurity Deficits
For the past four years, the annual Federal Information Security and Modernization Act (FISMA) audit has warned that the VA has lingering deficiencies across a wide range of cybersecurity areas, from agency wide security management programs to incident reporting and identity management.
Telemedicine Effective for Parenteral Chemotherapy Administration at VAMC
With patients in rural Nebraska who have trouble accessing the primary campus in Omaha, the VA Affairs Nebraska Western Iowa Health Care System (VA-NWIHCS) is using teleoncology and remote chemotherapy services to expand care to those veterans.
VA Tries to Address Societal Factors Leading to Veteran Suicides
For decades, VA’s response to preventing veteran suicide has been focused almost exclusively on healthcare, specifically mental healthcare.
Medications Might Skew Testing in One-Third of Older Vets With Hypothyroidism
Clinicians can find it difficult to manage hypothyroidism in older veterans, who tend to have a greater likelihood of adverse effects because of comorbidities, polypharmacy or both.
Veterans With CLL/SLL Have Suboptimal Adherence to New Therapies
Suboptimal adherence to new therapies for chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL), as well as related costs and healthcare resource use, demonstrate unmet needs in real-world treatment of the blood cancers, according to a new review.
Military/VA Search for New, Nonopioid Methods to Combat Chronic Pain
The last decade has seen health systems the world over shift away from using opioids for pain management. First there was the too-slow understanding that opioids are addictive and were being massively over-prescribed.
Depression Can Affect Dual-Task Walking in Multiple Sclerosis
Dual-task walking (DTW) can be a complex process for multiple sclerosis patients. A new study looks at what functions it requires.
MS Patients With RRMS Have More Anxiety Than Those With PMS
Multiple sclerosis patients in general appear to have higher rates of anxiety than the general population, but it remains unclear how much their disease course affects that response.
Community Care Coordination Puts Strain on VA Staff, Finances
Since 2014, when Congress passed the Veterans Access Choice and Accountability (Choice) Act, the VA has been paying for U.S. veterans to receive increasing amounts of private sector, non-VA, care.
Comorbidities Predict ED Use by Veterans With MS
Would addressing comorbidities in multiple sclerosis patients help reduce use of all-cause emergency services?
Cost of Community Care Has Risen Faster Than In-House VA Medical Care
President Joe Biden’s fiscal year 2023 budget request for VA totals $301.4 billion—an 13.3% jump from the FY22 enacted levels. This is in addition to an FY24 Advanced Appropriations request totaling $287 billion.
VA Researchers Identify Key Factor in ACCORD’s Increased Mortality
Optimal diabetes management requires striking a careful balance. Over time, high blood glucose levels impair cardiovascular function, leading to delayed wound healing, heart disease and elevated risk of stroke.
Is Heart Rate Variation an Accurate Biomarker for PTSD?
Could heart rate variability be an indicator of when a form of transcranial magnetic stimulation would be effective in treating post-traumatic stress disorder?
Pandemic Worsened Outcomes of Out-of-Hospital Cardiac Arrest
Outcomes of out-of-hospital cardiac arrest appears to have worsened, not only nationally but also at the state level, according to a new study focusing on Texas.
Height Might Be a Risk Factor for Several CV Conditions
Height appears to be an unrecognized non-modifiable risk factor for several common conditions in adults, according to a study using data from the VA Million Veteran Program.
Facility Performance Metrics Unavailable With Spokane EHR Rollout
When VA’s new electronic health record (EHR) went live at the Mann-Grandstaff VAMC in October 2020, the system did not have the metrics in place to allow the hospital to measure how the facility was performing, according to a recent study released by the VA Office of the Inspector General.
Economic Burden of PTSD Is ‘Staggering,’ New Treatments Needed
PTSD can have a profound effect on quality of life and emotional well-being. Symptoms such as nightmares, difficulty sleeping or concentrating, as well as thoughts of self-harm can continue or reemerge throughout life.
Increased Risk of Cardiovascular Mortality in U.S. Veterans Linked to Over- and Under-Treatment With Thyroid Hormones
Both over-treatment and under-treatment with synthetic thyroid hormones are associated with an increased risk of cardiovascular mortality in U.S. veterans, according to a new study.
Prescribing of Antipsychotic Medications for Dementia Dropped Overall at
VHA nursing homes are prescribing fewer antipsychotic and anxiolytic (anti-anxiety) medications for dementia patients, but the overall prescribing of other psychotropic and opioid medications increased, according to a new study.
VA Researcher Focuses on How to Prevent Staff Burnout at VA
For the past five years, Kara Zivin, PhD, MS, MA, has been “chasing burnout,” working to understand what causes it, how to measure it and what are the truly impactful measures that a healthcare system can take to combat it.
Ground-breaking Study in U.S. Military Finds Link Between MS, Epstein-Barr Virus
Researchers with the Uniformed Services University of Health Sciences (USUHS) and the Harvard T.H. Chan School of Public Health appear to have solved one of the most perplexing mysteries in medicine: What causes multiple sclerosis (MS)?
Multiple Myeloma Patients Usually Respond Well to COVID-19 Vaccines
While about one-fourth of blood cancer patients failed to produce detectable antibodies after COVID-19 vaccination, those with multiple myeloma fared better than most.
Genetic 17p Deletion Doesn’t Affect MM Survival by Race
African Americans have an increased incidence of multiple myeloma (MM) but do not appear to be at a disadvantage in terms of overall survival, however.
Hormones Affect Sexual Function After AHSCT
How do hormones affect sexual function recovery after autologous hematopoietic stem cell transplantation (AHSCT), which is the standard of care for younger patients with newly diagnosed multiple myeloma.
COVID-19 Pandemic Hits VHA’s MOVE! Weight-Loss Program Hard
The VHA acted quickly to convert its MOVE! Weight Management Program for Veterans to virtual care using telehealth when the COVID-19 pandemic hit in early 2020.
Drilling Down in Past Studies Can Help Individualize Type 2 Diabetes Treatment
One size doesn’t fit all, even when it comes to deciding which Type 2 diabetes patients would derive cardiovascular benefit from intensive glycemic control.
Glitches, Legislative Objections Don’t Stop VA Electronic Record Rollout
VA recently launched its new electronic healthcare record system in a third region, despite evidence of problems with previous deployments and strong objections from legislators and oversight groups.
Diagnosis of Bladder Cancer Has Dropped During COVID-19 Pandemic
In 2020, compared with baseline years 2018 through 2019, more than 2,000 fewer bladder cancers were diagnosed in the VA’s healthcare system.
Using Chemotherapy After Noninvasive Bladder Cancer
Using one dose of intravesical chemotherapy immediately following surgery for nonmuscle invasive bladder cancer is recommended in national and international guidelines.
Extracting VA Data on Invasive Bladder Cancer
Bladder cancer is the VA’s fourth-most-diagnosed cancer, and early diagnosis is important because, if the tumor spreads outside the bladder, the five-year survival rate is only about 38%.
VA AIR Report Outdated Because Pandemic Effects Weren’t Considered
Some of the data which the VA used to support the recommendations made in its Asset and Infrastructure Report (AIR) is outdated and flawed, VA leaders recently admitted.
Speech Therapist Finds Way to Make Dining More Dignified at CLCs
For residents of VA’s Community Living Centers, dignity is a precious resource. Patients who are there for short rehab stays may be struggling with new, frustrating limitations.
Tracking How Much COVID-19 Vaccination Was Distributed, Lost in Early Rush
In an effort to improve future efforts, data has been made available on initial COVID-19 vaccine shipments and wastage across the United States, which occurred shortly after those vaccines became available.
Safety Procedures Aren’t Always Followed at DHA Facilities
Dez Del Barba was only a short way into Army basic training at Fort Benning, GA, when he began to experience escalating pain in both legs. Physicians wrote it off as simple muscle soreness.
Obstructive Sleep Apnea in Aging Women Tends to Differ From Men
Obstructive sleep apnea, a disorder associated with persistent collapse or narrowing of the upper airway during sleep, has been linked to several detrimental outcomes including excessive daytime sleepiness, high blood pressure, neurocognitive decline and metabolic disorders.
Smoking History Affects Overall Survival in Women With Breast Cancer
Largely because of its association with conditions such as lung cancer and cardiovascular/pulmonary diseases, cigarette smoking is the leading cause of preventable morbidity and mortality in the United States, with about 480,000 deaths each year attributable to the habit.
Future Employers Might Not Know About Problem Clinicians Fired by VA
A recent investigation by the VA Office of the Inspector General (OIG) found widespread noncompliance by VA facilities in reporting healthcare professionals whose conduct or incompetence led them to be fired to state licensing boards (SLB) or the National Practitioner Data Bank (NPDB).