Whether the Veterans Administration actually becomes a national leader in health reform remains to be seen, and veterans who recall waiting months to see a VA doctor will probably chortle at the prospect. But by building on the efforts of his predecessor, George W. Bush, President Barack Obama appears to be pushing the VA medical system that way.

In recent years, the agency has harnessed technology in a way that few major health systems can, continuing to post patient medical records electronically so they can be shared easily within the system.

On April 9, 2009, Obama ordered the VA and the Defense Department to create a lifetime electronic medical record for all members of the armed forces, which can follow them from base hospitals and clinics to VA facilities. Known as the Virtual Lifetime Electronic Record, or VLER in the acronym-enamored government, the system is supposed to provide a "seamless transition” from active duty to veteran status, the White House said, and make for better cooperation between vets' public and private medical providers.

On research, the VA's budget is set to expand by 13.7 percent in 2010, to $580 million. But add funding provided in last year's stimulus package and its research budget is closer to $1 billion, according to the American Association for the Advancement of Science, which tracks government research funding.

Regarding accountability, the VA has expanded a fellowship program that puts physicians into the agency to develop and implement new ways of improving health care at the the agency. It's called the National Quality Scholars Fellowship Program.

Again, making the VA a leader in national health care reform may prove an expensive and uncertain prospect. But Obama has gotten the effort going enough to rate this promise as In the Works.