Nationally, VA completed more than 61.5 million appointments between July 1, 2014 and July 31, 2015. This represents an increase of 2.36 million more appointments than were completed during the same time period in 2013/2014. Veterans have access to outpatient care at more than 1,200 locations; acute inpatient (hospital) care at 144 locations; Community Living Centers (CLCs) at 134 locations; and residential rehabilitation at 114 locations.

 

While bureaucratic problems such as wait times for appointments are well-known publicly, VHA is known for delivering some of the highest quality health care services of any medical system in the United States. Given the overall public confusion about VA, can you give us a sense of the state of the VHA today?

With the implementation of VHA’s “Blueprint for Excellence” we are going through a major transformation focused on the veteran and providing consistently high-quality health care that is timely, efficient, and effective. Our goals are to improve performance, promote a positive culture of service, advance health care innovation for veterans and the country, and to increase operational effectiveness and accountability.

VHA is investing heavily in improving diagnostics for TBI with cutting-edge efforts that focus on detecting TBI in veterans who have not been previously diagnosed with a TBI.

 

When you arrived and took over your duties this previous July, what did you discover was awaiting you, and could you characterize the top initial priorities for action that you found?

My five priorities:

• Fix access
• Staff and physician engagement
• Consistency of best practices and resource prioritization
• Development of a high performance network
• Restore trust and confidence

Restoring the trust is the overwhelming and overarching objective.

Ultimately we are not going to be successful in the end if we don’t have that confidence back into our system.

 

Your background in the civilian world is as someone who emphasizes “best practices,” better care and service through continuing education and making organizations take a hard look at themselves and their people. What message do you think your recruitment sent to both the veterans community and your own organization about VA’s/VHA’s future commitment to improved veteran care?

Our stakeholders were ready for someone different who was outside of VA.

Of course, as you know, one of the things that I bring to the table is the private-sector perspective. I have not worked in the VA system for quite a long time. The last time was when I was a resident rotating through the medical centers, which was quite a long time ago.

 

VHA has been making a sustained and continuing effort to understand, assess, and treat traumatic brain injury (TBI). This has been a truly impressive effort, which is trickling down into the civilian world into places such as the National Football League and the automobile industry. So what is the current state of TBI understanding and treatment within VHA, and what do you see in the near future for veterans with this condition?

VHA is investing heavily in improving diagnostics for TBI with cutting-edge efforts that focus on detecting TBI in veterans who have not been previously diagnosed with a TBI. These efforts include novel research on cerebrospinal fluid and serum biomarkers, validating new positron emission tomography (PET) ligands, and devices that calibrate magnetic resonance imaging (MRI) so that repeated scans over time can be made reliably to monitor brain changes.