Caring for veterans: An interview with Glenn Costie

Name: Glenn A. Costie, FACHE

Position: CEO/medical center director

Hometown: Harrisonburg, Va.

Family: Married to wife Tammy Thomas

What drew you to working in health care for veterans?

My interest to work in health care started at an early age. My mother worked in the laboratory of our hospital and my first summer job was working in the dietetics department at the same hospital. After college, I was recruited by the Department of Veterans Affairs as part of a graduate engineer intern program and learned how to use my engineering degree to support the health care mission. My uncle also works in the VA Health Care System as a chaplain. So between my family involvement and my love for history and what our service men and women have done for our country, working in the VA system was a natural calling.

How does care for veterans affect you personally?

I relate my work for veterans to my father-in-law, who is a decorated Korean War veteran. He is very active in his veteran service organizations and lives in a very rural area of northern Wisconsin. The VA Medical Center in his community is very much a part of his health care needs. Whenever I am working on a veteran issue, I always imagine I am doing this for my father-in-law. As I said earlier, my uncle also works for the VA Health Care System. I am always working to exceed their expectations for our services that we provide to our veterans.

What are veterans' biggest needs right now, and how are you trying to address them?

The biggest need for the veterans in Southeast Missouri is access to care. In this highly rural environment, travel distances for care can normally be in excess of 60 minutes. One of my primary goals is to improve the veteran experience with our health care system. In support of that we have recently completed expanding existing outpatient clinics in Cape Girardeau and Farmington, Mo., and Paragould, Ark. We established a new outpatient clinic in Sikeston. We also are moving more care to these locations by including audiology and radiology services at these outpatient locations. Finally, we have installed at these outpatient locations home health care services which operate out of these cities. These actions serve to extend the care and bring the care as close to the veteran's home as possible.

The next challenge is providing specialty care to our veterans. If we are unable to provide the specialty care locally, the veterans must travel more than three hours to our VA Medical Center in St. Louis. In order to address this issue, we are making extensive use of our telemedicine technology. This technology is a very high-speed, high-resolution television conferencing system that we use in our outpatient clinics and in some cases right in the veterans' homes to bring specialty care to their location. Using specialty caregivers available to us from St Louis, Columbia and Kansas City, we hold virtual clinics for dermatology, mental health, eye and GI. We are looking at expanding these services to include oncology and ICU care in the future.

How has VA care changed over the years? There seems to be more emphasis on women's health and mental health, and added service connections.

This is a great question. You have hit on many of the special emphasis services we are providing to our veterans coming from the current wars. Female veterans are the fastest-growing area of our health care system. We have established a dedicated women's health care provider who runs a clinic specially designed to meet the needs of female veterans. We also have established these same services at our outpatient clinics. Our medical center has completed many infrastructure improvements to change our environment to be more supportive of female veterans. We held a very successful women veterans outreach program earlier this year. The event was attended by more than 200 and included a very effective partnership with the State of Missouri Women Veterans Coordinator.

We have also established dedicated staff to support our OEF/OIF veterans coming home from the current wars in Iraq and Afghanistan. These health care providers have received special training designed to support the unique needs of our current warriors. The multiple deployments and the repetitive reconnections with their family and friends provide a challenge never before seen by our veterans. This dedicated staff are very attuned to any mental health issues as well as suicide prevention.

The use of technology I mentioned above and the continued refinements of our world famous electronic medical record are the major changes we have seen in health care. Recent enhancements to our electronic medical record include a new radiology archiving package which allows the providers to retrieve diagnosis quality images from a dedicated file server in seconds anywhere in our health care system. Previous to this improvement, images could take as long as 10 to 15 minutes to download to the provider's screen. Our medical center is the first one in our region to successfully implement this new technology.

For veterans, what's the difference between going to a regular hospital and a VA Medical Center?

The main difference is the high quality care that is provided in the VA system. Through the use of the electronic medical record, the veteran is assured that 100 percent of his care is fully coordinated among the numerous departments and clinics that provide care. No other health care system has implemented this technology as fully as the VA Health Care System. Through our system, we make sure that all test results, past procedure results and chronic disease management information is available 100 percent of the time to any health care provider working with a veteran.

The camaraderie and honor that we communicate to our veterans is also a significant difference. The VA Health Care System provides care to not just patients but heroes who have sacrificed their lives for our freedom.

You've worked in VA health care for many years. How does Southeast Missouri differ from your other job locations?

The main difference is the rural nature of our environment. My past experience has been at primarily urban medical centers. The challenge for me personally is to assure that all of the veterans I serve receive the same high quality care. Just because a veteran happens to live in a rural environment should not mean they should accept less than the highest quality of care that I can provide. My mission is to personally assure all the veterans in Southeast Missouri and northwest Arkansas that I will work to assure they get access to all the care they need and have earned.

What's coming up next at the VA in Poplar Bluff? What do you most want to accomplish there?

My passion is to improve the experience of our veteran patients. We are establishing several new initiatives to accomplish that goal.

We have initiated an aggressive construction program valued at more than $60 million. This will provide a state-of-the-art urgent care center, new outpatient space for primary care and specialty care, and a new inpatient unit to serve our patients in the Community Living Center.

Eliminating homelessness in our veteran population is also a goal over the next four years. We have been provided with significant resources and are establishing partnerships with local religious and community organizations to make sure we identify all of the homeless veterans in our 23-county area. Once we identify a homeless veteran, we have a very aggressive and effective outreach program to tailor our service to meet the needs of the veteran. We also have proactively assessed our veteran population to attempt to identify triggers which might lead to homelessness. Both of these approaches will positively work to meet the goal of eliminating homelessness in the next four years.

On Jan. 8, 2011, the John J. Pershing VA Medical Center will celebrate 60 years of serving veterans. We are planning several events to acknowledge this significant accomplishment.

On Feb. 18, 2011, we will be hosting a national concert series called Valentines for Veterans. This medical center was honored to be one of 17 medical centers nationally to be selected to host a musical concert for veterans and the community. This is a community outreach event to be held at the Black River Coliseum featuring country music star Daryl Singletary. This event will be an opportunity to work with our community to celebrate veterans.