VA patient scheduling app still not ready for prime time

The Veterans Affairs Department has spent $127 million over nine years on an outpatient scheduling system that has yet to work and risks making similar mistakes in a second attempt at developing that system, the Government Accountability Office said in a new audit released today.

Unless the VA corrects significant management deficiencies, its second try at developing a scheduling system may succumb as well, GAO warned.

The Veterans Health Administration initiated the Scheduling Replacement Project in 2000 to update a 25-year-old outpatient scheduling system. The effort is part of the HealtheVet initiative, a larger departmentwide information technology modernization project.

VA terminated the Scheduling Replacement Project on Sept. 30, 2009, after spending $62 million on project planning, management, development and equipment, and another $65 million for a contractor to develop the application. The software that was delivered had a large number of defects, and VA canceled the contract, determining that the system could not be deployed.

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VA then initiated a new program, HealtheVet Scheduling, on Oct. 1, 2009, but has made limited progress, according to GAO.

“As of April 2010, the department’s efforts on this new initiative had largely consisted of evaluating whether to buy or custom-build a new scheduling application,” the GAO report said.

The VA’s efforts have been hindered by weaknesses in management which, if not addressed, may undermine the new project. These include a lack of adequate planning, lack of sufficiently detailed requirements, inadequacies in the testing program with software passing the tests with unaddressed critical defects, unreliable project status reports, ineffective identification and mitigation of project risks, and lack of corrective actions by oversight boards.

GAO recommended six actions to improve key processes at the VA:

• Ensure that acquisition plans include plans for competition.
• Use best practices for developing and managing requirements.
• Adhere to the department’s guidance for system testing.
• Ensure that earned value management is used effectively.
• Identify risks to the project and prepare strategies to mitigate the risks.
  
• Ensure that oversight is executed effectively.

Valerie Melvin, director of information management and human capital issues for the VA, said the department agreed with most of the findings and recommendations.