# Presentation: 326701

## SMARTVICVeterans Health Administration and Smart Cards

**Dennis M. Lewis, FACHE**
**Deputy Director**
**VA New York Harbor Healthcare System**
**New York, NY, USA**
**Dennis.Lewis@med.va.gov**

- CardTech SecurTech May 3, 2000

## The Department of Veterans Affairs

- 26 million Veterans and 43 million dependents
- Nearly one-third of the nation’s population are potentially eligible for VA benefits
- Second largest of the 14 Cabinet Departments - divided into three principal units - Veterans Health Administration (VHA), Veterans Benefits Administration (VBA)  and the National Cemetery  System (NCA)
- Facilities in all 50 states, Washington, D.C., Puerto Rico, Philippines, Guam and Samoa

- CardTech SecurTech May 3, 2000

## The Department of Veterans Affairs

- Nation’s largest medical system with 173 medical centers, 129 nursing homes, 35 domiciliaries and 370 community based clinics
- 58 regional veteran benefits offices providing monetary, disability, pension, education and vocational rehabilitation benefits
- 13 million home loans, and the nation’s largest insurance program
- 116 national cemeteries

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## Background

- 1930’s used metal plates, manually typed and maintained with medical record
- Late 1950’s saw introduction of paper cards
- Mid-1970’s introduction of plastic card
- Mid-1980’s introduction of automated card generation system
- Mid-1990’s introduction of automated veteran identification card

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## Background

- In 1993, the VA approved testing of a 1st generation veteran identification card.  VIC was too:
- Be a Universal VA Identification Card
- Prompt Health Care versus Hospital Care
- Improve services to veterans - seamlessly
- The national implementation of VIC was completed in April 1997
- The card was plastic, embossed, with a magnetic stripe and bar code

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## Background

- The embossed information allows for paper transfer of information, while the magnetic strip and bar code are electronic readable
- VIC rapidly “looks-up” medical and administrative information on the veteran
- It would allow for “electronic” registration
- Cards are personalized at each facility with five data elements including name, date-of-birth, social security number, claim number and service connection - non changing information only

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## Background

- VIC also contains a small black & white picture of the veteran with the card being produced in about one minute
- Takes approximately 1 minute to generate
- To date almost eight million cards have been issued

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## Background

- After a complete program review in the Fall of 1998, a recommendation was forwarded to Headquarters...”rather than make incremental improvements in the existing VIC, the VA should move to smart VIC cards.”
- The recommendation was approved in the Fall of 1999
- Additional recommendations addressed the need for significant cultural/operational changes in the way VA conducts it’s clinical and administrative practices

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## The fundamental inefficiency of America’s health care system is the timely matching of patient need to the most appropriate level of service at the most appropriate cost.				T.U. Gaboatie

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## Department of Veterans Affairs Smart Veteran Identification Card (SmartVIC)

- For the first time clinical as well as administrative data will be contained veteran’s identification card
- Administrative as well as clinical data will be subject to change
- The veteran’s medical information will be available at the right place and right time
- The veteran will be enabled to interact with the VA’s electronic system

- CardTech SecurTech May 3, 2000

## Department of Veterans Affairs Smart Veteran Identification Card (SmartVIC)

- The card as currently envisioned will allow for additional applications to be added
- Veteran  can make and/or change their appointments via kiosk
- Pharmacy refills requested
- Can change administrative information, mailing address, telephone number, insurance information
- In addition, it will contain DD214 information, disability rating, military service status and eventually, electronic purse functionally

- CardTech SecurTech May 3, 2000

## Department of Veterans affairs Smart Veteran Identification Card (SmartVIC)

- Veterans Health Administration currently has two pilots scheduled to provide proof of concept.
- The first, at Charleston, SC is a small scale home health care test involving 80 patients
- The second, at Honolulu, HI, is a combined VA/DOD multi application card and will involve approximately 500,000 veterans

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## Pilot Goals

- Will determine adequacy of visual ID with introduction of larger, full color patient photograph
- Determine adequacy of data base carrier for emergency data, demographics
- Convenience data instantly available in non-VA locations and to eliminate rekeying - demographics, emergency data, allergies

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## Pilot Goals

- Determine portability of patient information, specifically between VA and non-VA medical facilities
- Ability to satisfy interoperability requirements of both VA and DOD
- Realization of a “paperless” system and acceptance by veterans of a smart card

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## Pilot Goals

- Identify impact upon business processes - what can be eliminated, changed, streamlined?
- Identify non-VHA program needs, i.e., VBA, DOD, etc.,
- Identify technology requirements/barriers to the use of SmartVIC.
- Identify cultural barriers to use of SmartVIC and methods to address
- Develop strategies for the integration of SmartVIC with CPRS, CIRN, HEC, MCCF, VEP, Millennium Healthcare Bill, etc.

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## Practical Advice

- Veterans and staff will use the smart card when -
- Its’ adaptable
- Its’ integrated with other functions
- It leverages the strengths of your other systems
- Its’ personal and customizable
- It provides greater service for both veteran and staff

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## Summary

- Multiple rolls are seen for SmartVIC:
- Visual Identification
- Electronic identification (keys & certificates)
- Portable data carriers & pointer to additional data
- Significant reduction in patient errors
- Electronic Payment/Digital Purse
- Physical Access
- Information System Security

- CardTech SecurTech May 3, 2000