VA is moving forward with some innovations in predictive medicine. You may have heard some of these buzz words before; precision medicine, predictive modeling, predictive analytics, or calculated risk scores based on regression analysis. VA is enhancing its use of public health models to proactively identify and mitigate risks in our Veteran population.

The push toward predictive medicine (some say, the wave of the future) came out of the national office for suicide prevention. Clearly, everyone has a strong desire to decrease suicides among the Veteran population. The national suicide prevention team worked closely with VA information technology to develop a program that predicts those at the highest risk for a number of negative outcomes, including suicide. The program uses VA’s treasure trove of data (mostly from the Computerized Patient Record System, or CPRS) to identify Veteran’s at the highest risk.

When they examined the top 0.1% of Veterans in the highest risk stratum, they found 30% on the list had been identified as high risk secondary to clinical indicators. For instance, the Veteran had a high risk flag for suicide, were already in a high intensity program, were identified as needing higher intensity care, or were high utilizers of care. Seventy-percent of the 0.1% were not clinically identified as high risk, but were statistically identified high risk. This 70% are of concern as they may be floating under our radar and may fall through the cracks. It is common that Veterans who die by suicide are Veterans with whom we are not very familiar – Veterans that were not clinically showing high risk, but were very vulnerable.

The program not only identified high risk of suicide attempt and suicide, it also identified Veterans at high risk for accidental overdose, other causes of mortality (e.g., accidents and injury), involvement with violence (victim or perpetrator), and admissions.

The new VA program called Reach Vet has been created to give us a systematic way to identify these Veteran’s and consider ways to enhance care. We will be using this new program here at VA Puget Sound and it was recently launched across the Country. We will be sharing more information with you as it comes in. We look forward to presenting you with more information and the concrete tools to utilize the program in the coming months.

Please note: this article first appeared in the January edition of the Mental Health Service Newsletter, VA Puget Sound and was written by Mary Lou McClure, RN