- The House Committee on Veterans Affairs recently passed the VA Maintaining Systems and Strengthening Integrated Outside Networks Act (MISSION) of 2018, which includes policies designed to improve health data exchange at VA care sites to enable better-informed clinical decision-making and reduce opioid overuse among veteran patients.
Specifically, MISSION enables VA to share EHR data with non-VA healthcare providers “for the purpose of providing health care to patients or performing other health care related activities.”
Additionally, the act mandates that VA implement a process to ensure community care providers are able to access relevant patient medical history information, including medication prescription information.
VA officials intend to improve prescription drug monitoring by ensuring community care providers have access to complete patient medication histories.
“VA would be responsible for the recording those prescriptions in the electronic health record and enable other monitoring of the prescription as outlined in the Opioid Safety Initiative,” wrote the committee in the legislation.
In the interest of promoting the aims of the Opioid Safety Initiative, the legislation also enables VA care providers to utilize state prescription drug monitoring programs (PDMPs). PDMPs allow providers to electronically track the prescribing and dispensing of controlled drugs to ensure pharmacists can access information about patients’ prescription fill histories and more easily identify instances of potential misuse.
“Section 134 would allow any licensed health care provider or delegate to be considered an authorized recipient and user for the purposes of querying and receiving data from the national network of State-based prescription drug monitoring programs,” stated the committee.
“Under this authority, licensed health care providers or delegates would be required to query the network in accordance with applicable VA regulations and policies and no State would be authorized to restrict the access of licensed health care providers or delegates from accessing that State’s prescription drug monitoring programs,” the legislation continued.
In addition to promoting streamlined health data exchange between VA providers, community care providers, and PDMPs, the legislation also includes policies that may help to reduce administrative burden on VA care providers.
Section 2 of the bill calls for the development of a two-year pilot program that will increase the use of medical scribes in emergency departments and specialty care settings at ten VA medical centers.
A 2018 Journal of the American Board of Family Medicine study found medical scribes can help to reduce EHR use and improve levels of clinician satisfaction by removing EHR clinical documentation responsibilities from the provider workload.
“Under this legislation, VA would be required to report to Congress every 180 days regarding the effects the pilot program has had on provider efficiency, patient satisfaction, average wait time, the number of patients seen per day and the amount of time required to train an employee to perform medical scribe functions under the pilot program,” clarified the legislation.
The VA MISSION Act also includes policies that establish a Veterans Community Care Program and an Asset and Infrastructure Review (AIR) Commission.
“The President is committed to strengthening the VA healthcare system and offering veterans their choice of the best care to fit their individual clinical needs,” said the White House Press Secretary Sarah Huckabee Sanders in a public statement.
“This legislation is a key step to transforming the VA into a 21st century healthcare system that improves veterans’ access to timely and high-quality care, prevents inconsistent experiences, enhances veterans’ quality of life, and delivers the best possible healthcare outcomes to our Nation’s veterans,” she ehrintcontinued.
Department of Defense (DoD) Undersecretary Robert Wilkie is currently serving as the Acting VA Secretary in Shulkin’s absence. VA has not yet named a replacement for Blackburn.