The CBO report said many of VHA’s quality improvement programs use data from computerized clinical records to track both process and outcome measures, including risk-adjusted mortality and morbidity and that those programs have helped VHA to recognize problems in specific health care facilities as well as to improve performance throughout the agency.
Jha’s study also cites data collection and feedback through external peer reviews, performance contracts and incentives and health IT efforts that resulted in, for example, the VistA graphical user interface in use at VHA facilities as other key factors helping the VHA improve.
CBO said the agency’s “strong focus by management on key quality indicators can substantially improve performance, at least in terms of process indicators such as the administration of recommended laboratory tests or vaccinations.”
It also noted that rapid increases in annual appropriations for VHA, efforts to reduce waiting lists within the system, and expansion of mental health and other specialized services have contributed to the recent growth in spending per enrollee – which is roughly comparable to rises in spending per Medicare enrollee.