for Editor Donna, who had her eyes opened when Dr. Ward Casscells explained this and the lack of general coordination to her in 2009 in Q&A after his Mobile Health Expo keynote [TA 28 Feb 2011]. There seemed to be some movement forward last year after DOD and VA announced that recommendations on a joint strategy for EHRs would be announced in March 2011 (see link in article) followed by the May 2012 action of a VA and DOD agreement with 3M Co. to adopt their Healthcare Data Dictionary and structured data system for their EHR under development [Federal Computer Week 17 May].
- Here we have a rise in suicide among active-duty troops, care needed for soldiers rotating from Guard and Reserve units to combat duty and out again to civilian life and retirement, the signature wounds of this conflict being the hard to pin down and long-term TBI and PTSD–and EHRs aren’t interoperable.
- Here we have an inspector general’s investigation finding that nearly half of the veterans seeking mental health care for the first time waited about 50 days before getting a full evaluation, when the VA was saying 14 days was the norm.
- And there is a bigger problem–two-thirds of veterans who go on to commit suicide, according to Shinseki, are not enrolled with the VA, so we have an interoperability/communication problem between DOD records with civilian EHRs.
But the good news in this article is that telemedicine consults between patients and mental health professionals are actively being encouraged as well as online chat and texting (no quantification here). Every little bit helps and connectivity in this area does. Editor Donna asks for comments and further information links to this article, not only from readers in US but also from those internationally with experience with their armed forces health systems. This will continue to be followed; we owe no less.