VA responds to GAO criticism of IT management

The General Accounting Office this month released a report criticizing the Department of Veterans Affairs for failing to have a sound strategy for using and buying information technology.

The report comes only weeks after the VA announced it would create the Office of the Assistant Secretary for Information and Technology to help the department squeeze greater efficiency and better service out of its sprawling network of medical centers and benefits offices.

"One VA"

In a written response to a draft of the GAO report, Dennis Duffy, the VA's assistant secretary for policy and planning, concurred with GAO's recommendations and said the department's new assistant secretary would be key in helping the VA integrate its information systems so that the department can realize its "one VA" vision, in which each of the VA's 1,000-plus medical sites nationwide would have easier access to information at other VA sites.

The department has acted on two of the recommendations in the report, having decided in recent weeks on a suite of Microsoft Corp. software products to use across the agency and having created a new full-time chief information officer position [FCW, July 20].

"The fact that they did go ahead and announce that new position will go a long way to addressing needs," said Delores Moorehead, special assistant for information management and technology at the Senate Committee on Veterans Affairs. Members of the committee, including chairman Sen. Arlen Specter (R-Pa.), requested in September that GAO look into IT practices at the VA.

In the report, GAO took aim at how the VA has examined its business processes and linked them to IT, stating that the agency has not developed an overall strategy for improving its business processes. The strategy will heavily influence what kind of technologies the VA will use.

"In addition, VA has not institutionalized a disciplined process for selecting, controlling and evaluating information technology as required by the Clinger-Cohen Act," the report stated.

Observers see efficient use of IT as critical to improving the quality of health care delivered at VA medical centers, which serve a potential population of 70 million veterans and their immediate families.

"Integration strategy is crucial because health care is so complex," said Lewis Lorton, executive director of the Healthcare Open Systems & Trials organization, a nonprofit consortium that focuses on how IT can improve health care. "If you don't do things in a similar way, you're not going to be able to share information."

Sharing information is key if, in the short term, a doctor wants to make a fully informed decision on how to treat a patient based on the patient's medical history, Lorton said.

In the long run, Lorton added, IT becomes a tool for analyzing health care trends and determining where to spend resources.

"You get the ability...to treat the patient well because you can use all the information that you have in different places," Lorton said. "Information is what makes health care."

But getting to a point at which information can easily be shared will require intense management, observers said. "It's the leadership at the top that I perceive as missing," Moorehead said.

And, according to a source, management will have to do more than preach the "one VA" vision to employees and contractors.

"Anybody can have a vision. The big issue is how...you connect a vision with what you have right now," according to the source.