March/April 2009 20 Years in the Cabinet Paperless HR Fisher Houses Commemorating Lincoln VAnguard Features Coming Soon: Paperless HR 6 Personnel files will be just a mouse click away A New Approach to Healing the Invisible Wounds 8 Tuscaloosa VAMC program supports returning veterans and families 16 ‘A family’s love is good medicine’ 10 Fisher Houses provide a ‘home away from home’ for families Commemorating Lincoln 16 Milwaukee VAMC employees help reenact 16th president’s inauguration A Seat at the Table 20 VA celebrates 20 years as a Cabinet department Preserving Nation’s Oldest Civil War Memorial 24 NCA begins project to save monument at Cave Hill cemetery 20 Departments 3 Presidential Visit 31 Medical Advances 4 Outlook 33 Have You Heard 5 News You Can Use 36 Honors 26 Around Headquarters 39 Heroes 30 Introducing 40 20th Anniversary 33 VAnguard VA’s Employee Magazine March/April 2009 On the cover Vol. LV, No. 2 President Barack Obama speaks to Printed on 50% recycled paper employees gathered in the G.V. “Sonny” Montgomery conference room at VA Editor: Lisa Respess Gaegler Central Office on March 16. VA Secretary Assistant Editor/Senior Writer: Gary Hicks Eric Shinseki, whom President Obama Photo Editor: Robert Turtil praised for his distinguished career in the Photographer: Art Gardiner Army and his service to men and women in Staff Writer: Amanda Hester uniform, listens to the President’s remarks, at left. The President’s visit marked the Published by the Office of Public Affairs (80D) agency’s 20th anniversary as a Cabinet department. White House photo U.S. Department of Veterans Affairs 810 Vermont Ave., N.W. Washington, D.C. 20420 (202) 461-7427 E-mail: [email protected] www.va.gov/opa/feature/vanguard 2 March/April 2009 Left: President Obama’s stop at VA headquarters was the high- light of the two-day 20th anni- versary celebration; below: After the President departed, Secretary Shinseki joined employees in the VACO canteen for a cake-cutting ceremony, where he encouraged them to be full participants in the process underway to fulfill Obama’s pledge to transform VA for the 21st century. ROBERT TURTIL A Presidential Visit for VA’s 20th Anniversary as a Cabinet Department President Barack Obama joined Secretary Eric K. Shinseki at VA Central Office on March 16 for the celebra- tion of the department’s 20th anniversary as a Cabinet agency. A limited number of tickets to the program, held in the G.V. “Sonny” Montgomery Veterans Conference Center, were randomly distributed to headquarters employees by the Secretary’s office. The program was also broadcast live on the VA Knowledge Network, where employees across the nation could view it. In his remarks, Obama noted that on March 15, 1989, the day the Veterans Administration was officially elevated to a Cabinet-level agency and renamed the Department of Veterans Affairs, a ceremony was held to swear in VA Administrator Edward J. Derwinski as the first Secretary of Veterans Affairs. At that ceremony, Obama said, “President George H.W. Bush declared the mission of the agency is so vital that there is only one place for the veterans of America—in the Cabinet Room, at the table with the President of the United States of America. I could not agree more,” adding that he has pledged to transform the agency for the 21st century. After his speech, the President shook hands with several employees in the room, and departed. Secretary Shinseki then joined employees in the VACO canteen for a cake-cutting ceremony, with cake service provided by VA senior staff. For more on the 20th anniversary of the Department of Veterans Affairs, turn to page 20. MICHAEL L. MOORE outlook VAnguard Helping Clinicians and Patients Make the Best Choices Joel Kupersmith, M.D. Chief Research and Development Officer It was a medical story cel- health care decision makers three—did not benefit patients an important step toward ebrated for its immense impact across the country: “I have with acute kidney failure, personalizing care—that is, on cardiovascular treatment: drug A and B, or treatment compared to conventional tailoring health care to a spe- VA researchers, working with strategy A and B. Which is treatment. cific patient’s circumstances. Canadian colleagues, found best for my patient?” As health n Prolonged-exposure therapy In personalization of care, that patients with stable coro- care providers themselves, for post-traumatic stress dis- VA has exceptional research nary artery disease—in which most VA researchers are famil- order. VA researchers showed capability, thanks largely to its plaque buildup restricts the iar with these tough choices. that prolonged-exposure ther- electronic health record that blood supply to the heart VA Research is uniquely apy—in which therapists help supports sophisticated analysis muscle—often fare well with equipped to answer these types patients recall their trauma by integrating all elements of medication and lifestyle chang- of questions because of its en- memories under controlled a patient’s health history. VA es alone. A commonly used viable position within the Vet- conditions—helped women Research is also developing a treatment called percutaneous erans Health Administration, reduce their PTSD symptoms genomic medicine program to coronary intervention (PCI, the country’s largest integrated more than emotional support learn how a person’s genes can commonly called angioplasty), health care system. Because of and counseling focused on influence the way they react to which opens narrowed blood the multidisciplinary nature current problems. a drug or other treatment. vessels using a flexible tube of clinical study, all of VA’s n Two drugs for normalizing Armed with information called a catheter with a bal- research areas work collabora- heart rhythm. VA researchers about each intervention’s ef- loon at its tip, might best be tively to address the full spec- compared two drugs, amioda- fectiveness and a profile of reserved for patients with more severe forms of heart disease. VA’s comparative effectiveness research helps health The VA study, known by the acronym COURAGE— professionals answer the question: ‘Which health care short for Clinical Outcomes approach will benefit my patient the most?’ Utilizing Revascularization and Aggressive Drug Evalua- trum of veterans’ health care rone and sotalol, to determine individualized health factors, tion—is one among hundreds needs, with VA’s Cooperative which is better at correcting a VA providers can be maxi- of “comparative effectiveness” Studies Program often playing common heart rhythm abnor- mally informed and can best studies that have been under- a key role. mality called atrial fibrillation. educate patients to contribute taken by VA Research. Unlike CSP, a division of VA The drugs worked equally their preferences and values to studies that ask only whether Research that specializes in to initially achieve a normal health care decision-making. a new drug or other medical multi-site clinical trials and heartbeat, but amiodarone was Research findings alone approach works better than an epidemiological studies (stud- better at maintaining the regu- cannot improve health inert alternative called a pla- ies looking at the incidence lar beat. The two drugs were care outcomes. VA relies cebo, comparative effectiveness and cause of disease), was cited similarly effective in study par- on its “Quality Enhance- studies are head-to-head trials by the National Institutes of ticipants with ischemic heart ment Research Initiative,” to see which option works bet- Health as an example of “insti- disease, a condition in which or QUERI—a program that ter for a given health condition tutional completeness” for its narrowed arteries restrict the translates findings into better in a certain group of patients. ability to bring about change heart’s blood supply. patient care—to inform doc- These trials sometimes com- in clinical practice. In addition In addition to conducting tors and patients of important pare one drug to another. In to the lauded COURAGE clinical trials, VA Research, research conclusions that call other cases, they compare dif- trial, groundbreaking CSP-led through its “Evidence-Based for changes in practice. ferent approaches such as sur- comparative effectiveness trials Synthesis Program,” prepares VA’s comparative effec- gery versus an accepted drug include: and distributes reports based tiveness research helps health therapy, or different ways to n Intensive therapy to support on existing information about professionals answer the ques- deliver care to patients. kidney function. VA research- important health care topics. tion so crucial in this exciting, VA’s comparative ef- ers, in collaboration with By examining how yet sometimes bewildering, era fectiveness studies respond NIH investigators, showed therapies stack up against of burgeoning health care op- to a dilemma faced by health that delivering more intensive each other in defined groups tions: “Which health care ap- professionals caring for our na- therapy—for example, dialysis of people, comparative ef- proach will benefit my patient tion’s veterans, as well as other six times a week instead of fectiveness research represents the most?” 4 March/April 2009 VAnguard news you can use Celebrate VA Research Week 2009: ‘Turning Hope Into Reality’ “Turning Hope Into Reality.” contributions to the evolution n Genomics. This theme of VA Research of medicine.” VA research Week 2009—the annual Research Week opening is focusing celebration of department re- events