El Paso Joint Venture

2010 VA/DoD Joint Venture Conference

El Paso Joint VentureWm Beaumont Army Medical Center

El Paso VA Health Care System

El Paso Joint Venture

2

New Initiatives – Projects Closed

IDENTIFY ALL NEW INITIATIVES OVER THE PAST YEAR:

  1. Lab Integration:

2. Digital Mammogram Equipment:

3. CMS/SPD Equipment

IDENTIFY ANY PROJECTS OR EFFORTS THAT WERE CLOSED OR FAILED IN THE LAST YEAR:

1. JIF – Cardio Thoracic Surgery (Closed) – Successful: Brought CTS into WBAMC and recaptured 60+ cases annually with at least 12 cases being Veterans.

 

El Paso Joint Venture

3

Joint Venture Performance Measures PMs USED TO TRACK JV SUCCESS:

1. Access availability

2. Workload

3. Timeliness of actions 4. Patient Satisfaction

DATA SOURCES USED FOR THE PMs: 1. CHCS

2. AHLTA

3. Work Group reports

OUTCOMES FOR EACH PM LISTED:

1. CTS very successful. Open access based solely on need. 2. CTS has meet its annual goals of 12 minimum VAB patients and 60 total patients. FY10: 68 total cases, 17 VABs. 3. Central Materiel Services initiative has been successful in terms of the integration of EPVAHCS staff into WBAMC CMS department. Installation of EPVAHCS purchased CMS equipment is in progress.

El Paso Joint Venture

4

Access to Military Installation Procedures

REQUIRED ACCESS PROCESS and POLICIES FOR VA BENEFICIARIES and/or EMPLOYEES

TYPE OF VISITORID BADGE*

PRIOR COORDINATION

VA APPOINTMENT DOCUMENTATION / VERIFICATION

VISITOR CENTER

VA EMPLOYEE DVA NO NO 

NO 

VA PATIENTState or

VA ID NO NO 

NO 

VA PATIENT ESCORT State NO 

NO NO 

VA PATIENT VISITOR State  NO 

NO 

NO 

* Enter Type of ID Required: ( DoD, DVA, GOVT, State, Post or Base)

El Paso Joint Venture

5

Access to Care and Referral Management

ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT:

  1. DoD system cannot get CPRS consult directly

2. DVA requirement for PCP initiated consults on most referrals. Causes delays while clinic waits for authorization.

3. EPVA finds delays in WB specialty care consult review cuts into time to meet access standards.

4. WBAMC specialist deployments & WTU access priority affect availability for VA beneficiaries.

5. VA’s inability to view AHLTA encounter info consistently via Remote Data View-VistA Web.

RESOLUTIONS TO ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT:

1. WBAMC has provided EPVAHCS ability for a select group to enter consults into CHCS.

2. EPVAHCS provided POC for consult issues. WBAMC monitors their requests and contacts POC .

3. WBAMC developed adhoc CHCS report which allows monitoring of EPVAHCS submitted consults.

4. Special situations/cases are brought to Liaisons who work with clinics directly.

5. Situation was reported to national level IT for both DoD and VA. It is being worked . 

El Paso Joint Venture

6

Future Initiatives and/or Proposals

NEAR TERM (1-2 YEARS) INITIATIVES:

  1. Westside El Paso combined CBOC - Primary Care Clinic

2. Radiology Department Integration

3. Pharmacy Integration

4. DES – Disability Evaluation System (Spring 2011)

LONG TERM (>2 YEARS) GOALS / INITIATIVES / STRATEGIES:

1. Integrated / Co-Located Health Care Center

 

El Paso Joint Venture

Mission To improve the quality, efficiency, and effectiveness of the

delivery of benefits and services to veterans, service members, military retirees and their families through an

enhanced VA and DoD partnership.

Vision Statement (adopted 9 Dec 09)

“Establish a collaborative system of care for DoD/VA beneficiaries in an integrated medical center under Army command and control and a shared DoD/VA governance structure that achieves seamless

delivery of services for beneficiaries, continuity of care, quality care, and cost effectiveness.”

Future Joint Venture Federal Campus

El Paso Joint Venture

CONOPS signed by Principals on 4 Jan 2010

Governance:– One governance structure– WBAMC Commander exercises command and control (C2)

over the integrated Army/VA Medical Center.– EPVAHCS Director exercises complete authority over separate

VA outpatient services.– Joint Army/VA representation on medical and leadership

committees and on the joint medical staff.

Strategic Planning Focus:Will consider the DoD, Army, DVA and VHA strategic priorities,

missions, and guidance during program development.

CONOPS Review

El Paso Joint Venture

Daily Operations FrameworkObjective: combine services where feasible to reduce

duplication and increase efficiencies.– Integrate specialty care services as possible, or co-locate

with option of integrated administrative support.– Known, current exception: In-Patient Mental Health Care.

• WBAMC will have a separate AD inpatient unit, staffed and operated by and for the Army.

• VA will perform cost/benefit analysis to determine if a second inpatient mental health unit is needed.

– Staffing and Resources will be consistent with workload between DoD and VA beneficiaries.

CONOPS Review

El Paso Joint Venture

Emergency Department 3,880 (10%)

Outpatient Visits 4,426

Same Day Procedures 191

Inpatient Cases 1,169 (18%)Bed OccupancyOverall: 20%

Medicine: 35%

Medical ICU: 30%

Cardiology: 38%

Coronary Care Unit: 46%

Surgery: 25%

Surgical ICU: 28% As of Jun10

Overall Average Length of Stay is equivalent between VABs and DoD retirees.

VA Patient Activity at WBAMC FY10