VA Can Accelerate Advances in Medicine by Unlocking Its Data

Written by: Dr. David Shulkin, former Secretary of Veterans Affairs

According to the World Health Organization, we've entered an era of astonishingly rapid healthcare innovation, especially in the digital sphere. As a result, the U.S. Department of Veterans Affairs (VA) is investing in modernizing its systems to better care for those who have served our country. Recently, the VA established the VA's Digital Health Office to develop and optimize advanced digital technologies, aligning resources and priorities to maximize the impact of these digital health solutions on the healthcare experiences of veterans.

In addition to its mission of caring for the health of our nation's heroes, the VA contributes to the research and discovery of medical advances that improve the health of all Americans. However, medical research is among the areas impacted by recent technological advances, particularly research using big data and real-world data. As the largest integrated health system in the country and with 35 years of electronic health records, the VA generates a vast amount of data that could help unlock a wealth of new clinical insights from a diverse and inclusive patient population. However, the VA is currently hesitant to share data with the private sector due to concerns about privacy and security.

Protecting veteran data is paramount for several reasons. Firstly, veterans' health records contain sensitive personal information, including medical histories, mental health records, and potentially stigmatizing information. Unauthorized access to this data could lead to identity theft, discrimination, and breaches of personal privacy. Moreover, many veterans have unique health conditions related to their service, and unauthorized data access could lead to misuse of this sensitive information.

Data de-identification

While veteran data must remain protected, there are now tested ways to share data that ensure the security of patient identities. De-identification techniques such as data anonymization and encryption can protect patient privacy while allowing researchers and healthcare providers to access valuable information for medical advancements. Strict data governance policies and secure data-sharing frameworks can further mitigate risks, ensuring that data is used responsibly and ethically.

Despite its impressive use of data, the VA could do more to take full advantage of these tremendous data assets. It has the potential to uncover even greater opportunities to advance healthcare by working within public-private partnerships to expand its dataset. Data-sharing agreements between the VA and the private sector could accelerate further discoveries in medicine, helping to close gaps in patient care and leading to better treatment options for both veterans and the general population.

Cardiovascular disease

A prime example of this potential use of VA data assets is in the realm of cardiovascular disease (CVD), where large, at-risk populations remain untreated or undertreated. CVD is the leading cause of death in the U.S. and has an even greater prevalence in veterans than in the general population. Over the past several decades, VA screening programs have led to individualized preventive interventions and early treatment options. Yet, many patients are still not properly identified and, therefore, not treated with preventive therapies.

In the private sector, clinical data registries have become vital contributors to medical research, offering unique insights into real-world patterns of patient care-including in the area of CVD. For instance, the American College of Cardiology (ACC) sponsors the National Cardiovascular Data Registry (NCDR®), a suite of clinical data registries that provide a longitudinal view of the presentation, progression, management, and outcomes of CVD patients as they receive care and treatment from multidisciplinary care teams. Operated in partnership with the ACC, the Veradigm Cardiology Registry (formerly the PINNACLE Registry) is the largest outpatient quality improvement registry, encompassing more than 20 million patient records to capture data on coronary artery disease, hypertension, heart failure, and atrial fibrillation.

The power of clinical data registries

Clinical data registries such as the Veradigm Cardiology Registry are invaluable to the future of cardiovascular medicine. The Veradigm Cardiology Registry exemplifies how such registries can help improve cardiovascular care: A review article published in the Journal of the American College of Cardiology reported an overall improvement in care processes for patients participating in the registry between 2013 and 2017.

These and other privately operated data registries present the VA with an opportunity to improve the size and diversity of existing datasets. By sharing de-identified patient data related to CVD health with private sector registries, the VA would unlock the potential to deliver improved cardiovascular information at the point of care and advance next-generation research. Research advances could also lead the VA to further benefits, such as targeted interventions for disease management and population health initiatives, progress in heart disease treatment, and improvement of the lives of heart disease patients.

Public-private partnerships in the VA's future?

No health system in the U.S. may be better equipped to use data to identify at-risk populations than the VA, and it has an excellent opportunity to partner with the private sector in data sharing. By engaging in public-private partnerships and embracing innovative technologies and opportunities to use structured and unstructured data in novel ways, the VA could work toward its goals of closing gaps in care for at-risk populations and providing best-in-class care for all veterans-while simultaneously capturing and harnessing vast patient data to improve care for all Americans.

By collaborating with industry partners and embracing opportunities to use patient data in new ways, the VA could become a shining example of a new standard of care for all Americans while helping this country close critical health gaps in communities with the greatest need.

About Veradigm®

Veradigm is a healthcare technology company that drives value through its unique combination of platforms, data, expertise, connectivity, and scale. The Veradigm Network features a dynamic community of solutions and partners providing advanced insights, technology, and data-driven solutions, all working together to transform healthcare insightfully. For more information on Veradigm, visit www.veradigm.com, or find Veradigm on LinkedIn, Facebook, Twitter, Instagram, and YouTube.

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