Post-9/11 veterans group’s project to modernize VA healthcare includes suicide prevention focus
A leading veterans organization for post-9/11 servicemembers is spearheading an initiative to modernize healthcare operations across the Department of Veterans Affairs, with the project outlining an initial set of priorities that include suicide prevention and opioid-free pain management.
Iraq and Afghanistan Veterans of America announced the launch of the effort — called the Modernization of Veterans Healthcare Project — at the National Press Club on Thursday. The initiative is being led by David Shulkin, who served as VA secretary from 2017 to 2018 during the first Trump administration, and as undersecretary of health and head of the Veterans Health Administration from 2015 to 2017 during the Obama administration.
In an interview with Nextgov/FCW ahead of the launch event, Shulkin called the project “a big tent approach” that can ideally provide “a galvanizing call for all those that have been advocating for veterans’ health issues.”
The initiative is currently focused on seven priority areas when it comes to enhancing veterans’ healthcare services, although Shulkin said the list is a starting point and will not represent the full scope of the effort.
In addition to suicide prevention and opioid-free pain management, the project is also examining issues surrounding toxic exposure; community care; payment reform; transparent and public reporting of VA performance data; and the creation of VA centers of excellence for complex and specialized conditions.
In a speech at Thursday’s launch event, IAVA CEO Kyleanne Hunter said the effort “is not here to rag on all the things that are wrong,” but rather to convene a host of stakeholders — veteran service organizations, researchers, policymakers, veterans and others — to help VA modernize its healthcare operations with an eye toward the future.
“The way healthcare is delivered has changed astronomically since the last time there was comprehensive reform to the VA,” Hunter said. “Advancements in technology, advancements in telehealth [and] advancements in early and preventive screenings all must be incorporated to ensure that veterans care remains the state-of-the-art care that we have in this country.”
During remarks at IAVA’s project launch event, Shulkin also noted that suicide prevention is a key priority “because we’re simply not making the progress that all of us want to see.”
While VA has drastically increased funding for its suicide prevention initiatives over the past two decades, the number of retired servicemembers who have died by suicide has remained largely unchanged. The department’s suicide statistics, which some outside groups have said are an undercount, report that roughly 6,500 veterans take their own lives each year.
“This is a tough issue, and so we need to continue to keep that as a priority and a focus, and figure out, are there new things out there that we can be looking at — whether it’s the use of artificial intelligence as an additional modality, or whether there are new approaches that we can help in trying to solve this really, really tough problem,” Shulkin said.
VA has already been experimenting with using some emerging tech and AI capabilities to enhance its suicide prevention initiatives, including the use of a machine learning-powered tool that was launched during Shulkin’s tenure as VA secretary to identify veterans in the top 0.1% tier of suicide risk. Department officials have stressed that these capabilities help to bolster clinician-led outreach or to train Veteran Crisis Line responders, and are never meant to replace human interventions.
While technology-based modernization solutions are one focus of the effort, Shulkin also said the project will be exploring uses of non-opioid, FDA-approved pain medications and other treatment advances.
“In the veteran suicide autopsy reports, which are done on veterans who take their life, the number one clinical symptom is chronic pain,” Shulkin told Nextgov/FCW. “You can also look and you can see the relationship between untreated depression, post-traumatic stress. You can see the impact of even something like insomnia or tinnitus. And so therefore, I do think that we need to get much better at effective treatments. And when it comes to chronic pain, I believe we are still seeing far too many people that are being treated with opioids, and we’re seeing opioid use disorder and substance abuse leading to self harm and suicide.”
Since the project has just begun, IAVA is continuing to engage with subject matter experts and outside organizations to bring their perspectives into the fold. Hunter said IAVA plans to establish a dedicated website for the effort, as well as release quarterly reports and launch a dashboard to track the initiative’s progress.
