Thank you.
Good afternoon. I'm Gail Graham from the veterans health administration, the last of the three administrations we'll discuss. We were specifically asked to talk about digitization of medical records. We have an electronic health record that we've been using for about 20 years. I'm going to tell you just a little bit about the eligibility for health care.
Currently, as was discussed under benefits administration, health care is provided to those who are service-connected veterans, those who have a financial need determined by a means test, or those who, by virtue of serving in combat, are provided a five-year eligibility for health care services. We deliver health care directly through over 1,800 sites of care, including hospitals, nursing homes, domiciliaries, and clinics. We also administer a large purchase program for health care that runs in excess of $2 billion. We have a foreign medical program through which we pay for health care services provided to veterans living in foreign countries. We have a lot of rural areas, common with your country, and we are using telemedicine quite broadly in those areas.
Ms. Fischetti and I both represent the office of information within the veterans health administration.
So who are the veterans? We've talked about the different populations that each of us treat. Last year veterans health administration treated about 5.6 million veterans, and 209,000 of those came from current conflicts, what we refer to as Operation Enduring Freedom and Operation Iraqi Freedom. We do see the number of women veterans increasing, and it's projected to double in the next five years. The median age today of the veterans to whom we provide health care is 60 years. We have a large population of veterans of 85 years and older; we have about one million of those, compared to only 164,000 of that same age group in 1990. It's projected that the number of veterans over age 85 will grow to 1.3 million by 2011.
We spend a lot of time preparing for a different veteran of the future. We see the veterans who are coming out of current conflicts as Internet-savvy. They use that as their primary source of information, and we've had to move along to support that need. They're also convenience oriented--not quite as patient as our World War II veteran to wait for appointments or tolerate appointments and diagnostic services that aren't performed together, for example, or that aren't conveniently located. So we've opened a lot of clinics in the last few years that are located in small rural communities, and then we use referrals to larger medical centres.
We also find a more highly educated population, for example.
In certain segments, such as the Vietnam veterans, we see a population that is aging with disabilities, both a high rate of mental illness as well as physical ailments, which complicates treatment and broadens it to many areas and increases the need for geriatric intervention. We see projected needs higher in the area of mental health, for example, for post-traumatic stress disorder, substance abuse, and other mental illnesses, and a higher need for long-term care, which we are trying to satisfy in ways other than institutional long-term care.
As I said at the opening, VA has had an electronic health record, with components of it over about 20 years and full implementation over about the past 10 years. This enables us to have records that are available to practitioners wherever the patient may seek care. For example, with the population we have who are over 65, it's common that they would receive care in the northern part of the United States in the summer, and in the southern part of the United States in the winter. Our providers can look at these records regardless of where the patient presents for care. This also spans over different clinic settings and health care settings. For example, the records are available in acute settings, long-term care, and clinics, in the home health arena, and in telemedicine.
As I said, the most recent capabilities are really the ability to share these records, both the clinical information and the images from information such as diagnostic images. This is also an area where we're expanding our use due to shortages, for example, in radiologists. We're developing centralized reading centres, so the digital films are taken at the site where the veteran is located but are read elsewhere.
We try to make this data more easily accessible to the providers, but it's also accessible to our partners and the veterans benefits administration. As Mr. Pedigo mentioned, when they're processing claims, they also have access to this information as needed to adjudicate a claim for a veteran, and it may be at times used to do presumptive adjudication--for example, if there's been a presumption of connection between Vietnam service exposures and diabetes.
We've seen this adoption of the electronic health record help us in controlling health care costs in many aspects, from not repeating diagnostic tests because the results are available regardless of the location of the veteran to just being able to control our resources in a more equitable manner--using tertiary facilities as needed, but treating patients in a local setting whenever possible.
Thank you.