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Apple Update: VA Shadow Rulers Edition
Bruce Moskowitz, Marc Sherman. and Marvel CEO Ike Perlmutter's deep level of influence at the Department of Veterans Affairs continues to be revealed. Worth noting? Darin Selnick, now special adviser to VA Sec. Robert Wilkie, is a former high ranking member of the Concerned Veterans for America, a Koch Brothers-funded group. More from Isaac Arnsdorf at Salon.com:
The newly released emails also detail Moskowitz’s effort to get the VA and Apple to adapt his app. As a VA IT official described it in a May 2017 email, “We are utilizing the native iOS mobile app, Emergency Medical Center Tracker, that Dr. Moskowitz developed.”
Darin Selnick, a VA official who previously signed onto a 2016 proposal to dismantle the agency’s government-run health service, agreed with Moskowitz’s low estimation of the VA doctors’ input. “The VA staff has limited knowledge and experience, which is why you and the” academic medical centers “are so important to help the VA move forward,” Selnick wrote.
Selnick, who is now a special adviser to Wilkie, was the point person working with Moskowitz on the app, the emails show. “I like you are the implementer for VA,” he told Moskowitz in March 2017.
When Selnick said the VA’s information technology division could start working on the app, Moskowitz replied, “We need our specialist.” He then connected Selnick with his son Aaron, and Selnick introduced Aaron Moskowitz to Apple. (Aaron Moskowitz’s name is redacted from the emails, but his involvement was confirmed by four people familiar with the matter. He didn’t respond to a request for comment.)
VA officials identified major problems with the app’s usability and functionality. “Some of the code needs to be refactored and even rebuilt,” the IT official said in the May email.
Nevertheless, Moskowitz’s son Aaron joined a June 2017 conference call with executives from top medical systems and from Apple, including CEO Tim Cook. Moskowitz wanted the app discussed for five to seven minutes, according to the emails. After the call, Moskowitz named his son as one of the project’s “mid-level project managers.”
In preparation for the conference call, Apple employees and medical experts circulated a memo that assessed Moskowitz’s proposals, which were identified as coming from “the VA and the White House.” In the memo, Apple’s experts pushed back on Moskowitz’s app, saying that the VA’s website already offered a similar tool and that the national databases needed to make the app accurate didn’t exist. Instead, the memo encouraged pursuing a different idea (giving veterans a way to store their health data on their cellphones), which it said would “achieve the greatest benefit for our veterans in the shortest amount of time.”
Reminder: Apple sees potential profit in Veterans Healthcare Data
From our newsletter two weeks ago: Apple is looking at the Department of Veterans Affairs as its way into a larger healthcare information market. And unlike most private health providers, they’re not cloaking their intentions. Read more at The Verge.
This Week on Capitol Hill
Mental Health and the Wounded Warrior
The Wounded Warrior Project released its annual report on veterans mental health and suicide. Here’s the press release and several key findings:
To treat mental health concerns, including PTSD, the survey found that warriors:
- 71% chose a VA medical center as their top place to seek help for mental health concerns.
- 75% of warriors have healthcare coverage through the VA, up from 59% in 2014.
- 53% preferred talking to another veteran about their mental health.
- 47% used prescription medications to treat their mental health.
- 33% had difficulty getting mental health care, put off getting such care, or did not get the care they needed. Of those warriors:
- 19% did not seek treatment because they felt they would be considered weak.
- 19% were concerned that future career plans would be jeopardized.
- 18% felt they would be stigmatized by peers or family for seeking mental health treatment.
Military Sexual Trauma and suicide among women veterans
Voice of America reports on how women veterans ‘quietly struggle’ with sexual harassment, military sexual trauma, and suicide. Read it here.
Is the VA’s National Strategy for Suicide Prevention working?
Analysis from Russell Lemle at the Federal Practitioner:
In June 2018, the US Department of Veterans Affairs (VA) issued its National Strategy for Preventing Veteran Suicide, 2018-2028. Its 14 goals—many highly innovative—are “to provide a framework for identifying priorities, organizing efforts, and contributing to a national focus on Veteran suicide prevention.”
The National Strategy recognizes that suicide prevention requires a 3-pronged approach that includes universal, selective, and targeted strategies because “suicide cannot be prevented by any single strategy.”1 Even so, the National Strategy does not heed this core tenet. It focuses exclusively on universal, non-VA community-based priorities and efforts. That focus causes a problem because it neglects the other strategies. It also is precarious because in the current era of VA zero sum budgets, increases in 1 domain come from decreases in another. Thus, sole prioritizing of universal community components could divert funds from extant effective VA suicide prevention programs.
VA partners with T-Mobile, Walmart, and Phillips to expand telehealth
Read the Walmart press release. More from the Federal News Network:
The department announced Thursday it will partner with three private sector companies and two veterans service organizations to address VA’s access challenges and create more convenient opportunities for veterans to see doctors and health care professionals.
The announcement came at VA’s first-ever “Anywhere to Anywhere Together” summit in Washington. The department gathered its new partners, members of industry, medical professionals and others to solicit their feedback and ideas on how VA could forge a path for telehealth in the future.
The department is partnering with T-Mobile, which will host the VA Video Connect app on all service devices for free. Veterans who already have T-Mobile don’t need to take action to start or continue using the free service, said Mike Katz, executive vice president of T-Mobile for Business.
Video Connect lets VA providers use their mobile devices to see and speak with veterans on their own devices or home computers.
VA also inked new partnerships with Walmart and Philips. The department will work with Philips, the American Legion and the Veterans of Foreign Wars to set up 10 remote examination services at VSO posts across the country. Philips will provide video screens and other remote medical devices, so veterans can go visit their closest VSO post to see a VA medical professional, who, in some cases, may be based hundreds or even thousands miles away.
Our questions:
- How much data will T-Mobile, Walmart, and Phillips get to keep and use?
- Will there be any marketing or cross promotion from the private companies while veterans are using the service?
Quick Clicks:
- Press of Atlantic City: NJ Health Department offers a $250k grant to recreate VA’s care model for first responders and veterans
- USA Today: A veteran’s spouse discusses the economic, physical, and mental toll of being a caregiver
- WFLA Tampa: Blue Water Veterans march after continued denials of disability benefits
- CureToday.com: Myeloma outcomes for Black Veterans differ from non-veterans because of fewer treatment disparities within VA’s integrated system
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