Health care for veterans

Computerized medical records often translate to better health care for patients, recent studies show. And the Veterans Affairs system intends to give its patients the best possible care.

"Everything is built in electronically, from orders to doctor's notes," said Dewayne Coleman, health systems specialist for the VA at the Veterans Hospital in Poplar Bluff, Mo.

A common database with the St. Louis and Marion, Ill., hospitals "allows doctors immediate access to patient records at whichever facility in the area the patient might visit."

Coleman said the computerized programs allow better tracking for patient care. "This system eliminates wrong patient/wrong medications," he said.

The doctors also are alerted when a patient's medications are due and when they were administered.

Such state-of-the-art health care isn't just limited to patients at the hospitals in St. Louis or Marion. A clinic at the Missouri Veterans Home in Cape Girardeau also offers health care services to area vets.

The outpatient clinic offers primary care services and has two full-time staff internists and a registered nurse practitioner. Most services at the clinic include routine lab work, supplying medicatins and monitoring blood pressure or heart rates. Minor complications that don't require full hospital stays also can be treated at the clinic.

Psychiatric services are offered twice weekly by televideo, which allows patients to interact with a doctor who might be conducting the session at another location.

The Poplar Bluff, Mo., hosptial has inpatient services and strives for more rural access. The 40-bed hospital offers serves in cardiovascular, gatrointerology, urology and orthopedics. Coleman said the hospital doesn't do any surgeries, however. Those cases are transferred to a larger VA hospital, usually in St. Louis or Memphis, Tenn.

Offering telehealth services allows the Veterans Hospital and clinic to reach more people with health needs. Some of the programs include diabetes education and smoking cessation classes.

"It's hard to get someone to go somewhere to learn how to give up something they enjoy," said Coleman of the smoking cessation classes.

The Veterans Affairs system is moving from a hospital based system to an oupatient focus, so that more veterans in Southeast Missouri, and around the state can get the care they need.

Coleman expects that in-home care is the next direction for VA centers.

Sophisticated in-home care will allow doctors to better monitor those patients labeled as hard to manage. In-home computers and video phones will let doctors check a patient's heart rate, blood sugars, and weight evaluations.

Coleman cited one example of an individual who had made 30 trips to a VA facility for urgent care in a six month time span. After giving the patient an in-home monitor, he made six trips to the facility over the next six months.

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