Elevating How VA Delivers Health Care to Veterans
Background
The Department of Veterans Affairs (VA) health care system has over nine million veterans enrolled and serves more than 6.5 million unique patients across 150+ million appointments each year. These veterans have complex and evolving mental and physical health needs that require effective care regardless of where they live, the impacts of a global pandemic, supply chain interruptions, or clinical and technology capacity limitations.
VA’s Office of Information & Technology (OIT) is driving an IT transformation focused on improving customer experience and delivering the highest quality of care to all veterans. This includes expanding tele-health and overall access to care, delivering joint DoD-VA electronic health records, offering a seamless supply chain, and eliminating barriers to timely and high-quality care. At the center of this transformation is OIT’s Health Services Portfolio (HSP), which manages the full spectrum of Health IT (HIT) products that deliver digital and clinical point of care service for veterans.
Understanding the Need
To shepherd OIT’s transformation, HSP must create and sustain modern, integrated solutions that improve customer service, expand interoperability with VA and community care providers, and enable the continual delivery of secure, cost-effective healthcare to veterans. HSP needed a partner that could:
- Implement and maintain a constant stream of new products and enhancements.
- Address foundational challenges such as standardizing modern platforms and automation for products, optimizing OKRs, improving the use of data to inform decisions, and developing a realistic technology roadmap based on the product archetype.
- Help adopt and improve modern DevSecOps (DSO), Product Line Management, and platform and factory solutions.
- Create trusted business partner relationships with VHA, DHA, DoD, and HHS when there are significant differences in organizational construct, budget rules, and governance.
Our Solution
Since 2018, GovCIO has provided PMO and strategic services across the HSP’s nine product lines, which comprise 330+ products. Our team takes an enterprise approach to PMO support that incorporates a tailored Lean-Agile framework and cross-functional processes, tools, data repositories, communications, and knowledge management. This allows us to address the complexity of individual product lines and products, engage the breadth of stakeholders, and maintain a continuous focus while driving high-quality tactical performance.
In the years since the contract started, the needs of Veteran healthcare have drastically changed – from the MISSION Act of 2018, to Cerner platform adoption and VistA phase out, to the COVID-19 pandemic and need for virtual healthcare (telehealth), to the maturation of various technologies and management practices, such as DevSecOps and Product Line Management (PLM). However, GovCIO’s approach has continued to help HSP navigate these initiatives proactively and effectively, building a support model that stresses Veteran impact and empowers leaders to act and solve problems within VA’s delivery environment.
Focusing on HSP’s overall mission, GovCIO helped craft a clear strategic vision and translates this vision into tactical engagements that drive mission success. From the time any GovCIO team is stood-up, we work closely with VA PMs to coordinate current team efforts, tasking, and upcoming shifts in priorities. In 2020, we enhanced our existing process with a customized utilization tool that helps identify workload and/or resource trends while providing visibility into potential environmental risks; this tool has saved HSP an estimated $2M annually. Overall, GovCIO has completed 30+ strategic initiatives and developed a robust backlog to continue this momentum in achieving the HSP’s goals.
Results
Through our technical and strategic services, GovCIO has considerably impacted how the HSP executes work- improving the quality, reliability, and speed of its services and products.
An Agile, Product-Centric Organization
Working with HSP stakeholders, GovCIO moved HSP from a project-centric structure supporting 140 projects, to a product-centric organization composed of nine product lines, 41 projects, and over 330 products. Together, we achieved PLM Maturity Level 1 and 2 in accelerated fashion, establishing the HSP as the model for OIT’s other portfolios.
Improved Veteran Access to Care During COVID-19
GovCIO’s technical solutions, architectural design, and flexible Agile management provided efficient capacity planning and rapid response for VA telehealth services during the pandemic. Our team provided surge support for the Web VistA Remote Access Management (WebVRAM) application to accommodate a 600% increase in usage by VA telehealth providers and support staff, improving its efficiency and accuracy. We also improved outcomes within two complex and resistant areas: inter-facility and intra-facility scheduling. GovCIO’s process improvement recommendations reduced scheduling delays for telehealth appointments.
DevSecOps Adoption
GovCIO has helped institute a modern DevSecOps culture and practices across HSP products to manage the continual release of higher functioning, reliable Veteran health IT products. Working with HSP staff, we’re helping to deliver increased functionality and sustain IT products in manageable, iterative increments that best serve Veteran needs.
Advanced EHRM and Other Interoperability Efforts
GovCIO drives significant interoperability efforts, including the EHRM transition, Mission Act, and Veterans Data Integration and Federation (VDIF) project. GovCIO migrated VDIF-EP to VA’s AWS hosted Cloud, enabling more environments to support Mission ACT, OIT, and OEHRM and ensured VDIF Interoperability Readiness for EHRM ‘Go-Live Minimum. We’ve also integrated communication between Cerner, OEHRM, and VistA decommissioning to establish a workable path to Cerner adoption.