#As Veterans Day honors the past, let us also build for the future

We observe Veterans Day to honor and to offer our gratitude to those who have served our country. Having been privileged to lead the Department of Veteran Affairs, I’ve seen firsthand the incredible work of this agency whose sole reason for existence is to serve the needs of over 16 million veterans and their families. I’ve also been gratified to see the significant improvements made in recent years. As we honor our veterans today, let us also ensure that we continue to do better for those who have, without hesitation, sacrificed for and protected our nation. 

On this Veterans Day, let me pose five ways to build on recent progress.

Modernize. Because we owe our veterans the highest quality healthcare, we must see that they are cared for in modern facilities with cutting-edge technology. With the work of the Asset and Infrastructure Commission ended, VA must look to public–private partnerships for assistance in developing cost-efficient plans to replace aging facilities, as well as in updating its technological infrastructure. Additional investments in comprehensive, enterprise-level virtual care, artificial intelligence, and associated technology are necessary to meet the increasingly complex medical needs of veterans; burdensome administrative inefficiencies must also be removed, so that the VA can better deliver on its mission.

Establish veteran-directed care. With the creation of a veteran-directed system of care, VA can allow veterans to choose care either within the VA, or coordinated care within the private sector; additionally, veterans should increasingly be able to receive care in the home as an alternative to institutional care. By refining the current standards for the community care program and providing adequate and coordinated access to care, VA can significantly reduce critical wait times, and improved access will serve to address significant issues such as the prevention of veteran suicide. Also essential to the care of veterans are VA’s center of excellence and services that are dedicated to war-related illnesses. Further, seamless data interoperability between the VA and electronic health records across the full continuum of care is vital to a veteran-directed system of care.

Advance models of care delivery. VA has been a leader in interdisciplinary care models, particularly the integration of physical health and behavioral care, and has also demonstrated the effectiveness of team-based approaches in managing chronic illness. VA must expand these programs and their capabilities in predictive analytics and proactive outreach campaigns. VA must continue to address the social determinants and integration of peer support in its clinical care models. VA’s research organization, so important for improving models of care, can work to share their understanding of better ways to reduce infections and antimicrobial resistance. In doing so, VA will serve not only veterans but millions of others around the world.

Accountability. As a public agency, VA is accountable for its critical mission. Transparency regarding the fulfillment of its goals, such as the public posting of wait times, infection reporting data, adverse events and quality metrics are essential to maintaining high levels of performance and public trust.

Benefit redesign. Many veterans still wait too long to receive the benefits they deserve. While passage of the PACT Act was a significant step in the right direction, VA must now deliver on its commitments to address the health consequences of toxic exposures and conditions such as post-deployment respiratory disorder. The VA should initiate new thinking for a redesign of the benefits system in a way that can obviate the need for additional legislation. Such thinking should be expansive and creative; updating the roster of benefits can include adding new ones, such as sperm cryopreservation. The expansion of VA Research using synthetic data sets will allow VA to study best practices in conjunction with the private sector and, in determining what care is most effective, improve outcomes for our veterans across the board. 

On this Veterans Day 2023, let’s recommit to providing veterans with the world-class care and services they deserve. While considerable progress has been achieved in recent years, there is much more to be done to honor our obligations to those who have served.

The Honorable David Shulkin MD was the Ninth Secretary of the Department of Veterans Affairs.