Allow software to improve VA anti-suicide efforts
Suicide is the 10th leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention, and veterans are at higher risk than the general public. According to the U.S. Department of Veterans Affairs (VA), an average of 20 veterans committed suicide each day in 2014. The VA also reported that in 2016 the rate of suicide was 1.5 times higher for veterans than non-veteran adults, after adjusting for age and gender. This is a public health crisis, and doing everything possible to address it is something we all owe our veterans.
Veteran suicide prevention is a tremendous challenge and one that is exacerbated by the fact that, according to the VA, only six of the 20 veterans committing suicide each day in 2014 were actual users of VA services. Even when a veteran is receiving services at the VA, it is typically very tedious to methodically track and manage the care for high-risk patients because much of the workflow is manual. To make matters worse, suicide prevention is not the primary focus of most electronic health care records (EHRs). EHRs are a general tool that serve many needs, but they are not focused specifically on suicide prevention workflows.
Thousands of dedicated professionals at the VA take heroic action each day to manage the care of at-risk veterans. But, because no one can be perfect, this is a poor way to ensure a highly reliable system of care. The manual and siloed processes being followed today are tedious and heavily reliant on humans to repeatedly check the medical records of hundreds of patients to ensure everything that needs to occur has occurred. It makes the task of finding potential defects in the process like trying to find a needle in a haystack or like trying to boil the ocean. One defect in the process can be the difference between a suicide occurring and one being avoided.
During recent visits to VA facilities, I spoke with case managers who are working hard every day to provide care excellence. A single VA facility can have hundreds of patients with known high risk for suicide, with only a very small team of individuals tasked with monitoring and surveilling their care. The dedication of these VA employees is an inspiration to us all. However, such workloads are not sustainable and these heroes need help. What is required is a software platform that leverages the power of technology, analytics, clinical business intelligence and data visualization to relieve these heroes of tedious manual work.
These modern options are available today and the adoption of these technologies married with committed change management can make all the difference for veterans in need. Software solutions that can help the VA methodically manage the care of high-risk veterans are key to ensuring and monitoring compliance with complex suicide prevention care pathways.
These tools can be integrated with a facility’s information systems, permitting tracking of activities and the deployment of clinical business intelligence for the identification of defects in the process at the time they occur. These solutions put the right information at the fingertips of case managers, suicide prevention coordinators and facility leadership in real time across mobile and desktop devices. They also help the VA standardize, measure and improve suicide prevention efforts.
An analogy to what is needed is what happens on a commercial aircraft. The flight crew goes through myriad safety checks before takeoff. However, after takeoff the crew engages computers to actually fly the plane, and monitor and record the hundreds of minute flight corrections made during the trip. If human action is required, the system notifies the crew. Computers are far more accurate and efficient than humans can ever be at carrying out standardized tasks, freeing humans for higher level activities.
That is what suicide prevention efforts at the VA require, a software-powered platform that can track how each high-risk veteran’s care is progressing — one that can identify events and automatically notify members of the suicide prevention team when issues arise or aspects of the veteran’s care are out of compliance. This will free caregivers from the need to spend so much time on vital but time-consuming manual chart reviews and data abstraction, and provide more time for actual veteran care. It will also provide data to help the VA measure how effective its various processes truly are, a key step on the road to being a Learning Healthcare System as defined by the Institute of Medicine in 2015.
VA suicide prevention team members need the best tools possible to fulfill their missions. No one should have to be a hero every single day just to make the system work. I’ve had VA program chiefs tell me these software automation solutions are exactly what is needed to deliver better veteran care.
Tragically, not every suicide can or will be prevented. But the right technology can change the future for many veterans, delivering critical insight at just the right time. It’s past time for these solutions to be deployed at all VA facilities.
David LaBorde, a physician, is CEO of Iconic Data Inc. and a strategic adviser to DSS Inc., a health information software development and systems integration company. He previously worked for McKinsey & Co., where he focused on providing advisory services to health care provider organizations.