VA gets new tool to speed up claims processing, reduce backlog

DoD opens its electronic medical records to VA claims processors for the first time. The goal is to shave days or weeks from the time it takes VA to decide disa...

For the first time, claims personnel in the Department of Veterans Affairs are getting something close to on-demand access to the Defense Department’s medical records they need in order to decide the cases of recently separated military personnel.

VA has long sought the technology that would let it see the DoD service treatment records of new veterans.

VA officials say the labor-intensive process of hunting down paper medical records so that claims adjudicators can decide disability benefits cases has been one significant bottleneck in the process and one contributor to the VA’s claims backlog, which stands at 397,000 cases as of this week.

The two departments are hoping a new system that went online last month will mostly solve the problem.

The Health Artifact and Image Management Solution (HAIMS) gives VA electronic access to a complete, certified and final military medical record for any veteran who left the military after Jan. 1.

Maj. Gen. Richard Thomas, the director of health care operations at the Defense Health Agency, said the files VA sees will be a combination of scanned paper documents and electronic data from DoD’s electronic medical record system, AHLTA.

“When a separated service member or veteran files a claim, a VBA claims adjudicator then establishes a claim in the Veterans Benefit Management System. The system initiates an automated request for the service treatment record (STR), and when the requested record has been located and retrieved, the system alerts the claims adjudicator that the STR is available to support the claims process,” Thomas said Wednesday at a House Veterans Affairs Committee hearing.

HAIMS has hiccups

DoD and VA already had been using a similar system to share medical records between their two hospital systems, but Defense officials say the new capability is the biggest contribution they’ve been able to make so far to help VA cut down its disability claims backlog.

But the deployment of the system, which is still in its initial operating capability phase, hasn’t been without glitches. VA users reported receiving duplicate records, and sometimes the records of two different veterans in a single file.

The American Federation of Government Employees, which represents VA employees, told lawmakers that HAIMS and VA’s Veterans Benefits Management system are not well-integrated.

“We do have some issues we’re working through,” Dave Bowen, the Defense Health Agency’s chief information officer, said. “Some of our workflow issues on the DoD side still need to be refined. I know we have one instance where a document was misclassified, and so it showed up in the wrong section of the service record that transferred over to VA, but nonetheless was there. We have some issues around duplicate records showing up in VA side. We believe that might be a user education issue on VA side, where the claim is actually requested multiple times. We’re working out the details of all of those issues, we’re logging and we’re tracking them, we’re meeting every single day to get them resolved.”

Lawmakers also are pressing VA to solve problems with its own key piece of technology for claims management, VBMS. The new paperless system has suffered from periodic but serious latency issues as well as full-blown outages, sometimes several times per day.

VA says the system now has been rolled out to the point where 78 percent of its claims inventory can be handled through the more efficient paperless process.

But Eric Jenkins, a rating veterans service representative in VA’s Winston-Salem, N.C., regional office and an AFGE representative, said the downside is that when VBMS goes down, much of an office’s claims work grinds to a halt.

“In the last week, the VBMS systems were shut down for more than a day, and VBMS was restarted four other times during the week. Because I work in a completely paperless system, all the work I had completed during the day was now inaccessible until the system restarted. AFGE recommends the formation of an ongoing stakeholder work group to allow employees and veteran service organizations to work with management to address these serious implementation issues,” Jenkins said.

Not ready for prime time?

Veterans service organizations, which also rely on access to VBMS through VA’s Stakeholder Enterprise Portal, say they recognize the potential benefits of the electronic workflow process. But they also report fundamental usability problems with the system.

“VA is doing many things simultaneously. They’re working hard, and they’re doing more than any of their predecessors ever did,” said Gerald Manar of the Veterans of Foreign Wars’ national veterans service. “But this isn’t ready for prime time.”

Nor, veterans groups contend, is VA’s self-service Web portal, eBenefits, ready for prime time.

Last month, the service experienced a serious cybersecurity incident in which veterans who logged onto the site saw the personal data of other veterans. VA says an after-action review determined the software problem exposed the data of more than 5,000 veterans.

“We were doing an update to a system that feeds into eBenefits, and during our verification process we discovered that users on the system were able to see other users’ information,” said Lorraine Landfried, VA’s deputy CIO for product development. “As soon as we found out the new software was the cause, we removed that software, and as a further precaution, we took eBenefits offline to make sure there weren’t any other vulnerabilities.”

The initial breach happened Wednesday, Jan. 15. eBenefits remained inaccessible until the following Sunday.

A data breach core team VA established to investigate the incident still is conducting its review to determine exactly what went wrong.

VA officials say they’ve already built in additional error checks so that a similar software defect doesn’t create the same problem, and have offered credit protection services to the affected veterans.


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