Twenty-four veterans at the Martinsburg VA Medical Center died in 2022 and 2023 with a community care consult still unscheduled, and the chief of community care emailed their names to her team. This issue follows one referral from that hospital through the seven steps it travels between VA and the private doctor at the other end, finds the one date VA cannot produce, explains why six scheduling fixes since 2000 each repaired a single step, and sets out four things, each with an owner, that would give the trip a clock.
On September 15, in the telehealth and patient portal session of the Federal Electronic Health Record Modernization office's annual summit, a participant asked what the two departments are doing about DoD Instruction 6040.48, the 2018 policy that says the Military Health System will give every beneficiary a personal health record the patient controls. The panel answered that the portal is a different thing. The same session then called the portal a digital front door, a phrase DoW used in its own 2024 solicitation for one. This issue reads the instruction that says which of those is true, follows what the departments built and unbuilt in the eight years since, and ends with the two people the portal serves least: a sergeant who leaves in November and a fifteen-year-old who cannot log in at all.
On August 11 in New Orleans, the Director of the Defense Health Agency told an industry audience that the character of warfare is shifting and health IT is part of that shift. The FY2027 request his enterprise submitted asks Congress for $1.019 billion in medical research, forty-seven million above last year's ask. A Marine Corps procurement line called Field Medical Equipment went from $15.7 million to $227.8 million across the same two budgets.
The White House released two documents on July 21. The report names a million veterans' genomic records as an asset to be unlocked. The memo carries the deadline, assigns the work to six agencies, and never uses the word. The VA is not one of the six.
A veteran's record cannot move between two VA clinics running the same software. The fix everyone is watching is a $37 billion migration to a single system. The fix that already works is a federation layer moving 1.4 billion transactions a month. They solve two different problems, and treating them as one is why this debate keeps going in circles.