Due to the nature of their jobs, veterans and service members are given access to state-of-the-art medical technology to address their injuries. Medical implants are one important example of such technology utilized by the Veterans Health Administration (VHA). This can include a variety of health care devices, including cardiac, orthopedic, biological and neurosurgical implants.
Sometimes veterans even needs several devices, which can become hard to track. Unfortunately, this can lead to serious medical complications.
In order to combat the issue of tracking medical implants, the VHA is implementing a new comprehensive tracking system. Barcodes, standardized labelling and extensive inventories all help the VHA track the implants they use. While this type of system is not without its own challenges and complications, it has many benefits for patients. Medical implant tracking can provide the VHA with additional safety measures to protect veterans and service members, as well as increase the efficiency of their healthcare systems.
Why is it important to track medical implants?
There are several different implants medical professionals use to help treat veterans and service members. These include monitoring devices, pacemakers and artificial joints, among many others. Many surgical implants are crucial to the ongoing health and quality of life for the recipient. However, like all new medical technology, the use of these surgical implants also comes with several potential issues. These circumstances include:
- Disagreement between the medical provider and the Department of Veterans Affairs (VA) as to whether the implant was necessary, or which type of implant was required. Addressing these issues post-surgery can be difficult if there is no way to track the number, type of and cost of implants used to help the Veteran.
- Bulk implant purchases made by the VHA. Since implants are used so frequently, the VHA often buys these devices in bulk. Managing these high numbers in an effective way is extremely difficult without the ability to track individual implants.
- Safety recalls on certain implants. This is especially common with medical implants, since many implants used by the VHA feature new technology. When a certain batch of implants is recalled, every device in that batch must be checked for possible defects. If the VHA is unable to contact the recipient of the implant, his or her health is placed in danger.
- Medical emergencies. If a patient has an emergency and is unable to communicate, his or her doctors may be unaware of the presence of a medical implant. This knowledge may be crucial to understanding the needs of the patient and preventing a medical error.
- Misplacement of records. Long term records for an implant may be lost in the medical system without the infrastructure to manage them. This could cause problems for the patient if he or she must undergo medical treatment.
The cost and labor of identifying and contacting a patient with an implant are significant without any tracking system in place. More importantly, the amount of time it takes can be detrimental in the event of an emergency. This is why it is vital for doctors to keep track of implanted devices effectively.
Biological implants bring their own issues. These include bone and skin grafts taken from cadavers and transferred to patients who need them. Unfortunately, illegal trafficking of these tissues is common, which means that patients can potentially receive contaminated or sub-standard implants. If a problem is discovered with one tissue sample, every patient who received tissue from the same donor must be contacted. Otherwise, the long-term effects contaminated tissues cause can be detrimental to patients.
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For the VHA to accomplish this efficiently, there must be a system in place to efficiently track each medical implant. That way, patients can be contacted quickly and the risk of harm is reduced. More importantly, tracking these tissues from the time they are harvested can help ensure that all samples are from an authorized source in the first place.
Precedent for Implant Tracking
Implant tracking is not a brand-new concept, as many medical organizations already employ these safety measures. The Food and Drug Administration (FDA) system for tracking medical devices provides a possible basis for tracking VHA-issued devices. This system is known as a Unique Device Identifier (UDI), and is already used by several medical companies with notable success.
The standards for UDI focus on organizational steps, such as standardized labelling and prioritizing what data needs be recorded when tracking an implant. Many medical organizations that utilize tissue donation also have systems in place to track the tissue used in implants. This includes procedures for keeping patient records and contacting patients in the event of a recalled implant. These systems can provide a structural example of how the VHA can run their tracking systems.
Recently, the VA announced a plan to create a tracking system in collaboration with the FDA, the Department of Defense (DoD), and the Centers for Medicare and Medicaid Services (CMS). The support of these three other federal agencies is vital for the success of this new massive infrastructure. Each of the agencies can help address the needs, opportunities, limitations and challenges in creating this medical implant tracking system for veterans and service members.
This collaboration may prove particularly useful when it comes to maintaining universal standards for implant tracking, which is one of the goals of the registry project. One of the biggest issues faced is making sure the codes used to track the implants are recognized by all necessary bodies.
Challenges for Tracking Programs
The VA tracking program holds the potential to solve a variety of issues for the VHA and its patients. This includes digitally monitoring which patients have implants to avoid any medical errors. However, this system still has several challenges to face. These include the following issues:
- Compiling and maintaining records of the data required for each implant takes significant time and effort and requires the cooperation of many different agencies and governing bodies.
- Having all the necessary parties agree to the tracking system is key to the tracking program succeeding. If there are disagreements between agencies, this delays the process of developing a tracking system.
- The relationship between the VHA and implant vendors must be carefully controlled and managed for the system to be put into place. Vendors must be limited to using approved issuing agencies for implants, and must agree to adhere to the rules and regulations set out by the VA.
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