Sorry for the cryptic earlier post....I was just reviewing the VA Regulation on IDES (which is downloadable from the Resource section of this site) M21-1MR, Part III, Subpart i, Chapter 2, Section D, and noticed a few disturbing points.
There are a plethora of programs/sites that the VA and the military are supposed to use in processing claims. I am not sure I have hit them all- there are so many it is hard to keep track. But, here is a listing that I easily found:
VIP-Veterans Information Portal
CAPRI- Compensation and Pension Records Interchange
CHCS-Composite Health Care System
COVERS- Consolidated Veterans Records System
VTA- Veterans Tracking Application
AHLTA- Armed Forces Health Longitudinal Technology Application
SHARE
MAP-D- Modern Award Processing - Development
VERIS- Veterans Examination Request Information System
SAFE- Safe Access File Exchange
ExamTrak- (a web application that allows users to download examination reports they requested through VERIS)
VBMS- Veterans Benefits Management System
VADIR-VA Defense Information Repository
DPRIS- Defense Personnel Records Information Retrieval System
VIS- Veterans Information Solution
PIES- Personnel Information Exchange System
Virtual VA
VCIP- Veterans Claims Intake Program
Planning Systems Support Group’s (PSSG’s) web page
My point is that the VA's rating process for IDES cases relies on using at least 19 different programs or websites to process. I am not a computer genius nor am I an expert in healthcare administration. However, I do know this- having 19 different programs that need to interact with and provide information about a claim is a disaster.
There is a lot of waste and inefficiency going on in the processing of cases. Someone should be held to account.
Hey Jason, here is what those systems do and who they are primarily used by:
1) VIP: This is actually an umbrella term for many of the websites we use. VIS, VBMS (Veterans Benefits Management System), and others are part of this. Think of it like the home page for pebforum and the other websites are the actualy message boards within the site.
2) CAPRI: This is the method for the Veterans Benefits Administration to see Veterans' health records without allowing us writeable access (aka, we are not able to edit clinical notes, etc). This is used by military service coordinators to request examinations through the local VA medical center, and by raters to view any healthcare records in the VA system. Additionally, this system interfaces to a limited ammount with AHLTA so that the VBA can see what is in those records as well. The amount we can see is very very limited, usually only X-ray/MRI/CT results as well as a list of diagnoses and active medications (not the full clinical notes). This is still useful as we, at the VBA, do not have access to AHLTA. They tried giving us access a while back, but there were technical issues wherein they were not able to ensure that VBA employees would be unable to create/edit clinical notes in the system.
3) No idea what this is, I've never used it so I did a quick Google and it appears to be a component or predecessor to AHLTA, the military's side of the electronic healthcare records (EHR) system:
http://en.wikipedia.org/wiki/Composite_Health_Care_System
4) COVERS: This is purely an application for tracking the location of physical files in the VA. So, for example, when I finish my work on a case I use COVERS to digitally scan that folder into the next workspace, and then walk the folder over. The person receiving the folder then is supposed to scan the folder into their workspace so that, ideally, we know where all the folders are in the VA at all times. This is a stand alone application used solely for tracking of physical files, and one which we are using less and less as nearly all of our non-DES cases are scanned and the folders have been sent to long term storage.
5) VTA: This is an interface website of sorts, where both DoD and the VA track DES participants' progress and input information on their parts of the program. For the VA, it is also used to determine workload plans as it contains the information on how old a case is as well as updated information on any issues with the case (for example, if a claimed issue was not examined).
6) AHLTA: Military EHR, we don't get access to it currently. The ability to see both AHLTA and VA records would go a long way to helping the VA speed up claims processing, but seems to be a thorny issue for DoD and the VA for some reason.
7) SHARE: This is kind of the old master database, and it's something infrequently accessed. The only time we need to get into it is to a) establish the end-product (EP) 689 for a new IDES claim in the VA and b) process the final, monetary award. A rater hardly ever touches this system at the VA, usually all work is done by VSRs (Veterans Service Representatives).
8) MAP-D: This is a development tool for VSR's, MSC's, and RVSR's. Think of it as a collaborative notebook for the VA. The information shown to us is pulled from SHARE (Veteran's name, type of claim, date of claim, dependents, power of attorney, etc). The key use of this is to input work-process notes so that other VA members can view them. An example would be MSC's, who input the list of claimed issues here or that they have received your DD214 and uploaded a scan of it. That keys other people, like raters, to go look for that evidence. This system is, like SHARE, being phased out with the rollout of the web based platform VBMS.
9) VERIS: This is actually a subcomponent of CAPRI, and is the specific application used to request an examination for a Veteran. MSCs/VSRs use this to get the hospital to schedule your exams.
10) SAFE: This is used to exchange documents digitally between DoD and the VA, in particular the PEB case file, proposed rating decision, and any sensitive personal information. There is a file size limit, which is why it is not possible to just upload service treatment records to this and eliminate the paper copies. This is used by PEBLOs, MSCs, and VSRs.
11) ExamTrak: This is used to schedule and download exams conducted by QTC-contracted examiners (private doctors who do exams for the VA on a fee basis). Since these doctors are not VA employees, and are located everywhere in the country, they do not get access to CAPRI so we need to use this system. It's used by raters, VSRs, and MSCs.
12) VBMS: Again, an overarching program with many subprograms. VBMS allows us to rate cases (VBMS-R) and to see all scanned documents in a case whether in virtual VA (legacy e-folder system) or in VBMS itself.
13) VADIR: Used to exchange some EHR info between VA/DoD, mostly used by the doctor side of VA.
14) DPRIS: Used infrequently for 95% of DES cases but extensively for all National Guard and Reservist cases. Often, we need access to your full service admin documents. Some examples: To get the DD214, to verify combat prior to discharge via an award, to get service records from another service department (ie, if the Veteran served first in the Army, then got out and rejoined the Air Force 3 years later we will often only get the Air Force records).
15) VIS: Pulls from SHARE, and is most commonly used to verify service dates because it interfaces with DFAS payouts. Thus, even if we don't have copies of orders to active duty or a DD214 we can usually tell that someone was on some form of active duty. This system then guides us to develop for those orders/214s which we need to verify service/character of discharge.
16) PIES: This is the system used to send a request for documents to the Federal files storage sites for Veterans who served prior to ~1990, or who have retired and are filing a VA claim after a couple years. Used primarily by VSRsfor non-DES cases because everyone going through DES now is still serving or has recently served so their info is available in DPRIS/AHLTA. Much more useful for processing Vietnam/Korean War era claims.
17) Virtual VA: Our first, early 2000s crack at e-folders. Now supplanted by VBMS, but still active because not all MSC's can access VBMS from their workspace.
18) VCIP: This is used to track folders which have been sent to our contractor(s) for digitization(scanning), and doesn't really play a role in claims processing.
19) PSSG web page: I've never even heard of this website/application. A quick Google didn't reveal anything illuminating. I will say that I've never used it, or heard the name or acronym mentioned in the context of DES.
In the end despite the multitude of programs not all of them are regularly used and those which are are kind of important. You'll also notice that we have some legacy programs (MAPD, Virtual VA, SHARE) as we transition to VBMS. I'm directly involved in claims processing, and haven't ever felt hindered by the number of systems. To the point about decreasing accountability, these programs actually seem to aid in accountability. I can tell exactly who last worked on a case, what they did, and where the case is physically and process wise.
