Vision Center of Excellence
Update and VA Perspective
Claude L. Cowan Jr., MD, MPH
Deputy Director
DoD/VA Vision Center of Excellence
► Establishment
of center mandated by Congress
through 2008 NDAA
► Conceived as a center for the prevention,
diagnosis, mitigation, and treatment of military
eye injuries
► Development of Eye Injury Registry, improved
integration of VA and DoD eye care services, and
enhanced information sharing among primary
responsibilities
► Visual consequences of TBI identified as a specific
management challenge
► Collaborative
effort between DoD and VA
► Recognizes common patient base and need
for coordinated care
► Center is not a care center
► Information acquisition, assessment and
dissemination will be primary tools to foster
process improvement
Why VA collaboration?
► Nearly 900,000 OEF and OIF services members have
become eligible for VA health care since FY 2002
► 40% (nearly 350,000) have obtained VA health care during
that same time period
► Patients initially seeking VA care likely to stay within VA
system
► Extended f/u available through VA can provide long term
outcomes data
► VA acknowledged as leader in field of visual rehabilitation
VCE Early Milestones
► Selection of Director and Deputy Director
► Establishment of mission and primary focus
areas
► Identification of resource requirements,
including staffing, space, etc
► Development of registry technical requirements,
data elements and case definitions
VCE Focus Areas
► Informatics/Information Management
Develop data analysis tools
► Clinical
Care and Prevention
Improve process of care and injury prevention
► Research
and Surveillance
Expand the knowledge base on trauma and disease
► Rehabilitation
and Vision Restoration
Advance the science of rehabilitation/vision restoration
► Global
Outreach
Develop public and patient education programs
► Interim
space solution identified for initial staffing
actions
► Permanent headquarters to be located on campus
of NNMC
► Initial VA developed Registry CONOPS signed in
January ’09
► Integrated DoD/VA Registry CONOPS completed
and reviewed by Clinical Portfolio Management
Board in August ’09
► Funding stream for ongoing Registry function
identified in September ‘09
Registry next steps
► Initiation of implementation phase
► Identification of strategies for phased
implementation to allow functionality prior to full
development
► Creation of VA Data Store to create VA patient
data pool while registry development and testing
is completed
► Develop strategy for data abstraction required to
supplement registry data elements and validate
case definition codes
Other achievements
► Appointment of VA/DoD Clinical Systems Design
workgroup
► Facilitated development of eye/vision component for the
Joint Theater Trauma Registry
► Lead development of DoD Vision Research Steering
Committee
► Added other Federal as well as non-government
stakeholders to Steering Committee
► Facilitated development of August eye health initiative
implemented by DoD Office of Strategic Communications
Future challenges
► Completion of staffing plan
► Identify near term trauma care needs/gaps and
areas requiring process improvement
► Validate the utility of the Registry
► Foster translation of vision research initiatives
into improved care
► Champion further collaboration between VA and
DoD eye care providers