Ken Kizer: Transforming the VA

If you've spent any time in conversation with Medsphere—either live or via the Internet—you are probably familiar with Medsphere's basic premise: The VistA electronic health record (EHR) system developed by the U.S. Department of Veterans Affairs is the most successful health IT system ever implemented and can be leveraged to transform the rest of American healthcare affordably, rapidly and with amazing ease of adoption by physicians, many of whom used VistA during their VA rotations.

It's a strong statement, yes, but the VA experience backs it up.

Also worth stating, however, is that EHR implementation alone, though absolutely necessary, is not sufficient to achieve clinical transformation. In truth, the VA did not achieve clinical and systemic transformation until a leader with vision and the freedom to make dramatic changes was able to use VistA as a crucial tool for realizing that change. That leader, Kenneth W. Kizer, MD, served as the VA's undersecretary of health from 1994 to 1999. He currently chairs Medsphere's board of directors. Under Dr. Kizer's leadership, the ground shifted underneath the VA (metaphorically speaking) and the agency retooled itself to be able to start providing what many have called the best healthcare in America.

How truly revolutionary was the VA transformation Dr. Kizer engineered? Read what Philip Longman said in "The Best Care Anywhere" (Washington Monthly, Jan./Feb. 2005):

"A physician trained in emergency medicine and public health, Kizer was an outsider who immediately started upending the [Veterans Health Administration's] entrenched bureaucracy. He oversaw a radical downsizing and decentralization of management power, implemented pay-for-performance contracts with top executives, and won the right to fire incompetent doctors. He and his team also began to transform the VHA from an acute care, hospital-based system into one that put far more resources into primary care and outpatient services for the growing number of aging veterans beset by chronic conditions.

By 1998, Kizer's shake-up of the VHA's operating system was already earning him management guru status in an era in which management gurus were practically demigods. His story appeared that year in a book titled Straight from the CEO: The World's Top Business Leaders Reveal Ideas That Every Manager Can Use published by Price Waterhouse and Simon & Schuster. Yet the most dramatic transformation of the VHA didn't just involve such trendy, 1990s ideas as downsizing and reengineering. It also involved an obsession with systematically improving quality and safety that to this day is still largely lacking throughout the rest of the private health-care system."

Longman has much to say about Dr. Kizer's success at the VA (VHA) and what it could teach the rest of the healthcare industry. Follow this link to read the entire article.

Use this link to access data on the specific patient safety and disease prevention measures the VA put in place by 2003 and how those compare with national averages.

Click on this link to read Dr. Kizer's October 6, 2010, testimony to the Senate Committee on Veterans Affairs regarding the use of VistA and its broader application to healthcare in general.