The U.S. Departments of Defense and Veterans Affairs have done too little to smooth the way for the 2.2 million U.S. troops returning from Iraq and Afghanistan, many of whom have returned with multiple health conditions, according to a new report from the Institute of Medicine.
"[T]he potential long-term consequences of their service heighten the urgency of putting the appropriate knowledge and resources in place to make re-entry into post-deployment life as easy as possible," report co-author George Rutherford, head of preventive medicine and public health at the University of California, San Francisco School of Medicine, told NBC News.
The report stresses the need to integrate the two agencies' electronic health record systems, and calls each agency out for using unproven diagnostic and therapy tools, according to a report summary. It calls for evidence-based treatment for returning veterans' conditions, which can include traumatic brain injury (concussion), post-traumatic stress disorder (PTSD), military sexual trauma, depression and substance abuse.
An IOM report last summer blasted the DoD and VA for failing to keep track of the PTSD services provided and associated outcomes. The new report calls for evidence of effectiveness before treatments are rolled out nationally.
The mass of data collected by the two agencies, according to the report, could provide needed insight into the physical, psychological, social, and economic challenges facing returning service members.
Yet it adds, "The committee is unaware of any databases that fully integrate demographic and deployment data for service members with data that describes their health outcomes, treatment, access to care, or employment before and after deployment. The committee calls on the DoD and the VA to support comprehensive analysis of both departments' data to answer questions about readjustment that are not addressed by peer-reviewed literature."
The DoD and VA have come under heated criticism after ditching plans to build a joint EHR system from scratch. The VA and DoD pulled the plug on that project in February after the price tag had swelled to $12 billion. Officials from each said that instead, they plan to integrate their current systems using "existing solutions."
To boost access to mental health care, the VA set a goal of providing 200,000 remote consultations in 2012 through videoconferencing, up from 140,000 in 2011. In January, the VA awarded 33 grants to improve healthcare services for female veterans, including telehealth programs in rural areas.
Yet the massive backlog of claims means veterans can be left waiting months or longer to receive care.