What I'm Working On: Better Health, Better Care, at Lower Costs for our Veterans

Posted by Tonya L. Breaux-Shropshire

As recent media coverage has shown, few issues are as important to this country as healthcare for veterans. What most people don’t see, however, when they read the headlines, is the research that takes place behind the scenes on new solutions to our vets’ most common medical problems. For example, hypertension is the number one reason for a primary care visit, and that is one of my areas of research as a Veterans Administration (VA) Quality Scholar Fellow at the University of Alabama at Birmingham (UAB) School of Medicine. In particular, I facilitated first steps in how to boost blood pressure control in hypertensive veterans by using quality improvement tools, such as a process map, SWOT analyses, check sheets, and evidence-based interventions like “a hypertension bundle.” This bundle, which has been successful in one patient aligned care team (PACT) in the Primary Care Clinic at our VA Hospital, employs the electronic medical record, medication adherence assessment, and appropriate nontraditional care visits to achieve greater patient engagement, hence superior care for vets. What is more, the bundle could potentially lower costs by helping vets avoid expensive emergency room visits for what could be routine care.

Research into hypertension is not new for the VA system, which has led the way to blood pressure treatment and control. As early as the 1960’s, for example, the VA conducted pioneering studies to determine that blood pressure was a disease that needed to be treated to prevent heart attacks, strokes, kidney disease, and death. In addition, VA conducted one of the first studies that determined that step care, or medication intensification starting with one medication, is required for blood pressure (BP) control. Admittedly, much more needs to be done to improve primary care and access to care for vets. Yet, on many fronts, we are making real progress, including the availability of user-friendly resources, such as the My Healthy Vet program (https://www.myhealth.va.gov/index.html), TeleHealth (http://www.telehealth.va.gov/ccht/), and the Get Well Network (http://www.getwellnetwork.com/). Today, VA blood pressure control rates and target goals are higher than national goals, and I think that make sense, given the strategic and human importance of keeping our vets healthy. In fact, at the Birmingham VA, we recently improved blood pressure control over and above the VA target goal rate within 6 months. You might not read about that in the headlines, but that doesn’t mean we aren’t working 24/7, for better health, better care, at lower costs, for our veterans.