BRIEFING TO THE INDEPENDENT TELECOMMUNICATIONS PIONEERS ASSOCIATION (ITPA) A Glance Back at MyVA and A Look Forward to Choose VA What Does the Change in Motto Mean to Veterans and the Agency s Leaders and Staff who Care for Those who shall have borne the battle? David Cheplick Director, Solution Delivery, Endpoint Engineering U.S. Department of Veterans Affairs Office of Information & Technology (OI&T) Information Technology Operations and Services (ITOPS) October 5, 2017
DISCUSSION TOPICS What Precipitated the MyVA Agenda? What Was MyVA? What Did(Has) MyVA Accomplish(ed)? Why Did the New Administration and New Secretary Adopt Choose VA as their new Agenda? What is Choose VA? What Are the (Real not Sloganeering) Changes from MyVA to Choose VA?;l if any, What? What Future Perspective on VA Modernization is Provided by the 2018-2024 VA Strategic Plan? Lastly, Do Mottos Matter If the Mission Remains the Same? Office of Information and Technology 2
The VA Landscape: Circa 2014 How Does Secretary Bob McDonald Confront VA s Many Challenges and Establish a New Way Forward? 3 Office of Information and Technology
VA s Organizational, Political and Service Delivery Challenges: Unresolved Legacy Issues and New Era Issue Complexities Corrosive and Retaliatory Culture Seemingly Impenetrable Bureaucracy Significant and Chronic System Failures, including cover ups and data falsifications Too few doctors and clinical support staff at many VAMCs Lengthening wait times for both Health Care Appointments and Compensation and Benefits Adjudications Rising number of Veterans committing suicide Growing number of underutilized and unneeded facilities across the VA Increasingly hostile Congress and skeptical veteran service organizations Secretary Bob s Personal and Professional Challenges: If I don t fix it, who will? If not now, when? What Lessons Learned from Proctor and Gamble can I apply to VA? Am I a Change Agent that can Truly Improve Service to Veterans? Office of Information and Technology 4
The MyVA Agenda 2015-2017: Answer, Simply Stated, A Need for Enterprise-wide Organizational Culture Transformation 5 Office of Information and Technology
Secretary Robert McDonald s MyVA Vision - July 30, 2015 These strategies were shaped by the advice of the President, members of Congress, thousands of Veterans, leaders of our Veterans Service Organizations, our employees, and many other stakeholders. We were listening.
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MyVA s Legacy: Thank you Secretary Bob for your Corporate Change Agenda (but Don t Expect VA to Embrace It Long Term); and/or, Is MyVA the Foundation for Future Improvement to VA s Manifest Service Delivery Mission? 8 Office of Information and Technology
A Sampling of Changes Across the VA Enterprise Resulting from MyVA Initiatives (2014-2016) Reinvigorated emphasis on reducing wait times for medical appointments Expanded access to health care services through non-va community care programs funded by the Veterans Choice Program Increased hiring of more mental health specialists and staffing of the VA Crisis Hotline (VCL) Improvement in the processing time for backlogged disability compensation benefits claims Realignment of all VA organizations into one five district map Establishment of an Office of Accountability and Whistleblower Protection, Veterans Experience Office and OIT Enterprise Program Management Office Institutionalizing an OIT Buy-First rather than Build-First strategy Office of Information and Technology 9
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If It Was So Successful, Why the Rebranding of MyVA? What Does it Mean for OIT s Major Programs? Office of Information and Technology 11
New Administration, Secretary and Opportunity to Set Forth A New Narrative - but with some Holdover Personnel and Agendas Out with the Obama Administration, In with the Trump Administration Out with Secretary McDonald, In with Secretary Shulkin who came on board VA with Secretary McDonald in 2015 as the Under Secretary for Health Certainly not out with MyVA Workforce Chairperson, Scott Blackburn, who became Acting Deputy Secretary now soon to be Acting CIO Out with CIO Council but check swing with OIT CIO Thompson and Thomas, respectively, Obama holdovers notwithstanding acting CIO Blackburn range of skills...he is not a technologist So, will the next CIO be, skill-wise, more aligned with the IT vision of the Choose VA Agenda? Veterans Choice Program will be extended indefinitely; Does this mean Privatization of Health Care for Veterans? hold that thought for a moment privatization could cost $50-$100 Billion where will the money come from? VSOs worry that VAMCs could wither on the vine more to come with Choose VA Agenda you can be certain! What does the future hold: Veterans serving Veterans in VA Facilities vs Veterans finding Health Care Services in the commercial marketplace? Office of Information and Technology 12
What Changes (Real not Sloganeering) from MyVA to Choose VA; if so, What? 13 Office of Information and Technology
Choose VA New Driver for Transformation Since 2015, the MyVA initiative has been a catalyst for Agency-wide transformation and in 2018 VA will continue to build upon that transformation. Choose VA is a new enterprise-wide initiative to provide Veterans expanded choice and high quality care when and where they need it. VA has articulated five priorities to further encourage Veterans to trust that VA is doing the very best for them and their families. IT plays a significant role in Choose VA, and our resources will continue to be needed to support and shape the 5 priorities. Office of Information and Technology Choose VA Priorities. 1. Greater Choice for Veterans Redesign the 40/30 Rule Build a High Performing Integrated Network of Care Empower veterans through transparency of information 2. Modernize our Systems Infrastructure Improvements and Streamlining EMR Interoperability and IT Modernization 3. Focus Resources More Efficiently Strengthening of Foundational Services in VA VA/DOD/Community Coordination Deliver on Accountability and Effective Management practices 4. Improve Timeliness of Services Access to Care and Wait Times Decisions on Appeals Performance on Disability Claims 5. Suicide Prevention Getting to Zero 14
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OI&T BE SAFE Initiatives OI&T priorities and activities are aligned with the Secretary s priorities for the Department to enable success BESAFE commitments we made to the Veteran in 2017: Modernization of the Benefits Delivery Network (BDN) Modernization of Electronic Health Record system Modernization of VHA Appointment Scheduling Single source for Veteran Addresses Consolidating the Financial Management System (FMS) Implement Enterprise Cybersecurity Strategy OI&T s DNA is composed of four key principles: transparency, accountability, innovation, and teamwork. Office of Information and Technology 16
OI&T BE SAFE Initiatives demystified Modernization of the Benefits Delivery Network Ensure Veterans will continue to receive the benefits they have earned in a timely manner. BDN processes the bulk of Electronic Funds Transfer payments and home address checks. The proposed strategy is to migrate BDN capabilities and services to a modern platform such as BDN as a Service. Modernization of Electronic Health Record Expand interoperability with DoD and private-sector medical providers. VA will determine the best path forward, in collaboration with DoD, by July 1, 2017. Allows Veterans and their families better access to their health information. Modernization of VHA Appointment Scheduling Allows Veterans to make appointments with VHA and take control of their healthcare. We currently have several initiatives underway including: 1. VistA Scheduling Enhancements (VSE) 2. Medical Appointment Scheduling System (MASS) 3. Veteran Appointment Request (VAR) Single Source for Veteran Addresses Identifying a single source for Veteran Addresses will allow VA to more easily communicate with those we serve and ensure they receive the information and care they deserve. Authoritative repository for all Veteran identity and common contact/demograp hic data throughout the VA.. Consolidating the Financial Management System Simplify and improve accounting across the VA enterprise and allow VA to track budgeting and spending more easily. OI&T will replace capabilities offered by current VA finance systems with a cloud-based service offered to the VA by the Department of Agriculture. Implement Enterprise Cybersecurity Strategy Ensure that Veteran data is secure, available and safe from cyber threats. The Enterprise Cybersecurity Strategy five strategic goals: 1. Protecting Veteran information and VA data 2. Defending VA s cyberspace ecosystem 3. Protecting VA infrastructure and assets 4. Enabling effective operations 5. Recruiting and retaining a talented cybersecurity workforce Office of Information and Technology 17
OI&T BESAFE and the Secretary s Determination & Findings Decision to solicit an off-the-shelf commercial EHR directly from Cerner The Hope and Expectations: Enable true interoperability between DOD and VA EHRs Bring about seamless care fundamentally constrained by everchanging information sharing standards, separate chains of command, complex governance, separate implementation schedules governed by separate program offices and appropriation and a host of complexities requiring constant life cycle management. Leverage significant cyber-security enhancement already in place in DOD The RealPolitik: VA Leadership could not agree on a way forward since 2002 Leaving behind VA s M/VISTA programming legacy is a big gamble Politically, a win for the Administration Financially, a win-win for Cerner and DOD Nonetheless, VA s long-term investment in VISTA development is coming to an end for better or worse Office of Information and Technology 18
VA s Strategic Plan 2018-2024: What Does the Plan Portend for Veterans, Agency Personnel and the Private Sector for the Next Decade? Who will be the Winners and Losers? 19 Office of Information and Technology
Four Guiding Goals and Eight Sets of Objectives Veterans Choose VA Veterans Receive Timely and Integrated Care through their Lives Veterans Trust VA to be Consistently Accountable and Transparent VA will modernize systems and focus resources to be competitive VA will agilely adapt to changing business environments and veterans needs VA will modernize human capital management VA will institutionalize data-driven decision-making VA will modernize IT to deliver improved customer experience while decreasing its rate of spend Office of Information and Technology 20
VA s Business Strategy will bring New Approaches and Different Emphases to Forefront - Ensuring VA is a Veteran s First Choice Enhanced use of Telehealth and Tele-Radiology More use of cloud-based application hosting Faster application of VA research to clinical practice with an emphasis on advancing personalized medicine and genomics Enterprise-wide, institutionalized use of modeling, value analytics and forecasting to improve data-driven decision-making Greater leveraging of VA s graduate medical training programs Increased use of private sector and shared service providers for enterprise applications including Enterprise Health Record (EHR), Medical Appointment t Scheduling (MASS), Benefits Delivery Network (BDN), Financial Management System (FMS), Burial Operations Broader deployment of VA procured and provided, veteran-focused digital services including a Digital Veterans Platform and MyHealthyVET Office of Information and Technology 21
The Plan inherently contains Strategic Trade-Offs and Value Judgements to Best Serve Veterans (As Informed but Needful Consumers) and Preserve the Agency s Mission Responsibilities While VA s overall budget for FY18 was increased, the IT budget was cut by $250 Million No clear indications to date as to what the numbers will be for the OI&T FY 19 and out-year budgets The Secretary has announced that there will be an 80% Reduction of On-Going Development Programs over the next 18 months OI&T Leadership also projects Stop Actions on 240 of 290 Current Projects The Secretary clearly intends to support Veterans Choice through the Veterans Choice Program but will do so in a manner that ensures VA controls how the Program fosters and supports use of VA direct care services Office of Information and Technology 22
VA Mottos: A Short Parting Thought on The Enduring Legacy of President Lincoln and the Need to Continually Reinterpret the Message 23 Office of Information and Technology
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VA s Journey of Change VA issues Core Values June 2011 SEVCA Guidance VA s 5 Priorities March 2017 SECVA Stands up Modernization Office April 2017 18 Enterprise Initiatives Approved August 18, 2017 Modernization Way-Forward Drive SecVA Priorities Secretary launches T21 Initative, 2010 MyVA Task Force 2015 Executive Order 13781 March 13, 2017 Agency Reform Development, IPTs Final Agency Reform Plan to OMB September 11, 2017 26
Heart of our Mission We must assess VA through the lens of Veterans, their families, caregivers and survivors, and the American taxpayer What is best for Veterans, their families, caregivers and survivors? Ease Timeliness Quality Customer Service CLICK TO EDIT MASTER INTRO TITLE Click to edit Master Intro Sub Title Business Case Good for Veterans Good for Employees Good for Taxpayers U.S. Department of Veterans Affairs
VA s Mission Remains Steadfast; Its Challenges are a Constant Reminder that More Remains to be Done Kahlil Gibrain wrote Progress lies not in enhancing what is, but in enhancing toward what will be. Secretary McDonald made clear in testimony to Congress that VA is an invaluable part of the promise made to Veterans and MyVA inspired improvements will continue to be made to ensure this unique system is meeting the needs of veterans to the fullest capacity. Laverne Council encouraged her OI&T leadership team to build on success, advance toward a new framework and always remember why we are here and who we serve. Rob Thomas recently put his thoughts on record to VA OI&T staff noting We will build upon the best VA has to offer and we will continuously improve all of our outcomes, until all Veterans want to Choose VA. Secretary Shulkin recently stated: We know it is paramount that we increase our focus and intensify the efforts to improve how we execute our mission Veterans should and do expect that from us. We also recognize that incremental change is not sufficient to achieve the additional improvements VA and Veterans need and demand for restoring the trust of Veterans and the American public. 28
Modernization in Action CLICK TO EDIT MASTER INTRO TITLE Click to edit Master Intro Sub Title U.S. Department of Veterans Affairs
End State CLICK TO EDIT MASTER INTRO TITLE Click to edit Master Intro Sub Title U.S. Department of Veterans Affairs
QUESTIONS?? 31