Director's Message October 21, 2022

It is expected to improve everyone’s ability to work within our station, and to improve care for veterans.

The CBOCs need to be a seamless part of the VAPIHCS. That means that wherever you go, when you step into a CBOC, they should offer the same quality of care and meet the same expectations. It’s also important that my office is in contact with the CBOCs at all times in order to help ensure that their needs are being met.

Join me in congratulating our new CBOC leadership: Mary Benito at the Leeward CBOC, Dr. Fred Uhrle in American Samoa, Dr. Kevin McDermott in Guam, Brenda Hathaway in Kona, Kristin Cordaro in Maui, Dr. Harbor Wood on Kauai, Grace Pakele at the Windward CBOC, and Bernetta Backman will be temporarily acting as the CBOC Chief in Hilo. This new governance structure for the CBOCS will help us to improve communications, remove silos and ensure our CBOCs are operating smoothly.

Color of Care

Federal employees were recently given the opportunity to watch a movie produced by Oprah Winfrey called “The Color of Care.” This documentary discusses cases of health care disparities that were observed during the COVID-19 pandemic. I can’t emphasize how much I value equity and equality as guiding principles for my employees to follow. We here at VAPIHCS have a commitment to provide safe, compassionate, quality care to all veterans, regardless of their race, gender, or other factors.

I would encourage everyone to watch this documentary because the message is a powerful one. Seeing people talk about the loss of their loved ones is always hard, but when a death was preventable, it multiplies the despair that is felt. Let us strive every day in every way to improve our processes and our internal beliefs to move towards health care that works for everyone, and which is free from bias. I commit to that, and I expect all VAPIHCS employees to do the same.

VAPIHCS Talk Story

On Tuesday, June 28, 2022, we posted our first episode of our new podcast, called VAPIHCS Talk Story. The podcast now has over 5,000 downloads. I am committed to continuing to communicate in writing, in videos, and in all the mediums that we have used before. However, this new medium of information delivery will allow us to reach more people, and that is very important to me. Our job is to serve veterans, but we must also make sure that we communicate effectively with veterans, to ensure that they know about and understand all the benefits that VA can offer them, and about all the things that we are doing. If you’re not listening yet, tune in and check it out.

VA Services in Guam

The VA Pacific Islands Health Care System (VAPIHCS) covers 2.5M square miles, which includes the Hawaiian Islands, Guam, American Samoa, and the Commonwealth of the Northern Marianas (CNMI). Last week, we celebrated the 25th Anniversary of our Center For Aging (CFA) on Oahu, which is the oldest building in the Pacific Islands that was built by VA. In the past 25 years, we have expanded services by leaps and bounds, and we’re by no means finished. We are continuously working to get more services for veterans in every corner of VAPIHCS.

Recent media coverage in Guam has suggested that veterans there feel like VA does not hear them. I want to assure you: I hear you. We are working on your behalf. We have expanded services in Guam, and we will continue to expand further because we care about every veteran, and we’re not going to leave any of you behind.

October 24, 2022, through October 26, 2022, VAPIHCS is hosting an extensive Veteran Event “Community Call” at Top O’ The Mar on Nimitz Hill, building 295. There, we will be registering veterans who are newly eligible for services under the PACT Act. We will also offer diabetic foot checks, vaccines, blood pressure testing, screening for Hepatitis C and HIV, and more. We welcome all veterans in Guam to come out and talk with our staff. Tell us what is on your mind, and how we can help you. We care what you have to say, and we are listening. If you have any questions about this event, or about VA care, please call us at 1-800-214-1306.

We will also be appearing on the Vet Talk K57 Radio Program regularly, opening two Accessing Telehealth through Local Area Stations (ATLAS) booths in Guam, and working with Director Tim Aguon and Lucia Perez, Special Projects Coordinator of the Guam Office of Veterans Affairs to synchronize our efforts and tie-in additional resources amongst our Veteran Service Organizations and community partners.

Intimate Partner Violence Information Fair

On Wednesday, October 19, 2022, there was an Intimate Partner Violence Information Fair at the Spark Matsunaga Ambulatory Care Clinic (ACC). October is Domestic Violence Awareness Month, but this is a priority all year long a VAPIHCS. If you or someone you know needs help, please reach out. The number for the Veterans Crisis line is 1-800-273-8255, then press 1. You can also text 838255. You can make an appointment with Mental Health Services. Additionally, you can call our main line 1-800-214-1306, select option 4 to speak with someone in Mental Health Services. Other resources include:

National Domestic Violence Hotline:  1-800-799-7233 (SAFE)
National Sexual Assault Hotline:  1-800-656-4673 (HOPE)
National Human Trafficking Hotline: 1-800-273-8255

Women’s Health at VA

October is Breast Cancer Awareness Month, but it’s also a good time to talk about women’s health within VA. Within the catchment area of VAPIHCS, there are 5,837 enrolled women veterans, and 5,424 of those are actively receiving care from VA. These veterans are spread across the Hawaiian Islands, Guam, American Samoa, Saipan, Tinian, and Rota.  Women veterans have unique needs, and the VA is a leader in recognizing them. As an example, women veterans may need support for birth control, infertility, In- Vitro Fertilization (IVF) treatment, disorders and diseases more common in or specific to women, maternity, menopause, and pain management. VA provides women health services within each Community Based Outpatient Clinic (CBOC) to address these needs.

There are also more programs yet to come. VA has been approved to add services like breastfeeding classes to help women veterans with all aspects of their health care journey. In addition to this, clinics try to include the Whole Health principles that are applied across VA. Whole Health is about asking the veteran what is most important to them, and then suggesting programs and services that will help them achieve their goals. For example, a woman veteran may have the goal of being able to get down on the floor to play with her children or grandchildren. In this case, VA would want to offer classes in movement like Tai Chi, Yoga, to assist with flexibility and mobility overall.

From Maternity Care Coordination services to installing breastfeeding stations in locations across VAPIHCS, services are being added or improved constantly. Dieticians can consult with veterans and create an individual diet plan based on their needs and health concerns. VAPIHCS’s OBGYN Doctors and Primary Care Providers can review a woman’s file and give advice on risk factors they might face if they choose to become pregnant, as well as giving guidance on abnormal PAP smears, and other gender-specific needs. Veterans can consult with prosthetics for a lactation package, blood pressure cuffs, and more. The goal is to provide gender-specific primary care for all aspects of women’s health. That includes preventative services, mental health, osteoporosis prevention and treatment, breast health, pain management, and a holistic approach to care that is all-inclusive.

VAPIHCS is working every day to improve women’s health services. As more women enter the armed forces, more women become veterans. VA expects to see a surge in women veterans in the future and is increasing services and programs to meet the needs of those veterans. Robust programs have been developed and will continue to be developed to ensure that women veterans are comfortable coming to the VA, and to ensure that they feel welcomed.

Breast Cancer Awareness Month

Every October is Breast Cancer Awareness Month, an opportunity to spread awareness about the disease that kills nearly 41,000 women each year. VA Pacific Islands Health Care System (VAPIHCS) encourages all our women veterans to get regular screening, as early identification and treatment can save their lives. Patients can call 1-800-214-1306 to make an appointment.

Remember that while it is less common, men can also get breast cancer. Male veterans should also do self-breast exams and talk to their doctor if they have any concerns.

Pharmacy Week

This week we celebrated Pharmacy Week. The VAPHICS Pharmacy department is one of our most versatile departments. They service on-site care locations such as the Community Living Center (CLC), and veterans across the entire coverage area of VAPIHCS. Over 85% of the prescriptions that they fill are done through the mail, but they also have a drive-up area and a walk-up location on the second floor of the Spark Matsunaga Ambulatory Care Center (ACC). In addition to this, they work in collaboration with local pharmacies when necessary to ensure that veterans can get their medications.

Pharmacy gets a lot of compliments, and their hard work and dedication has not gone unnoticed. I’m very proud of our pharmacy department, and I want to extend a sincere thank you to everyone in that department. This week may be dedicated to appreciating you, but at VAPIHCS we value you every day.

Health Care Quality Week

This week was also Health Care Quality Week. VA is committed to providing quality health care to our veterans and has made many contributions to improving the health care experience for those who have served. One way we do this is through being a High Reliability Organization (HRO). Every employee should engage with the HRO process and continue to work to improve how we do things in order to improve patient outcomes. Another way we improve is through the Joint Patient Safety Reporting (JPSR) program. All employees should report any errors in JPSR, because this is another way that we can improve patient outcomes.

Our goal is to provide safe, compassionate, quality care to the men and women who have worn the cloth of our nation. Health Care Quality Week is a celebration of the work that we do, and the quality of care that we provide. We will always work to improve, and to expand our services to ensure that all veterans needs are met.

Records Management System Update

VA has been working to transition all care sites to a new record system called Electronic Health Records (HEHR). The decision has been made to delay further expansion of the program until June of 2023 pending changes to the system. VA remains committed to getting the new EHR right for veterans and aims ultimately to serve as a model for transformative health care innovation by using the same health record system as DOD and the U.S. Coast Guard and improving exchange of veteran medical information with participating community care providers.

Modernizing VA’s electronic health record is much more than a routine software implementation. It is a fundamental change in how business and health care work processes are performed within VA. It presents us with opportunities to transform the way we deliver health care, and to standardize that delivery across the enterprise to achieve improvements in patient safety and efficiency in health care delivery. Updates will be provided as the situation evolves.

Thoughts From Chaplain Charles Richie

There’s a story of a young boy who was walking along a seashore after a great storm had passed. The storm’s raging waves left countless starfish littered all along the seashore’s path. The young boy started picking up the starfish, one at a time, and would throw each starfish back into the ocean.

An elder man walked by and began laughing at the boy. He said, “Why waste your time throwing these starfish back into the water? You’re just one kid, and besides, there must be a million of these starfish out here, you’ll never get them all back in water.”

The boy replied “Yes, you’re right,” but as he threw another single starfish into the ocean, he said, “but I could change the life of this one,” and as he threw another starfish into the water, he said, “and I can change the life of that one.”

They both knew that they could not save every starfish, but that reality motivated the young lad to focus on the difference that he could make, instead of dwelling on what he could not do.

It’s been said that you may be one person to the world, but to one person, you might be the world.

It’s often easy to feel as though our efforts won’t make a great difference unless we have some great, spectacular opportunity. But life is chiefly made up of little things, little opportunities to make a difference each day.

Just as a pebble cast into the pond causes ripples that extend far beyond itself, our daily decisions each day often make an impact greater than we could quantify. Continue to do what you do for our veterans. Your service just might be leaving an enduring impact that will make a world of a difference in their lives.

One Team, One Ohana!

Adam M. Robinson, Jr., MD, MBA, CPE
Director, VA Pacific Islands Health Care System
VADM, MC, USN, (RET)
36th Surgeon General, USN
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