VA's Gould puts systems into service for vets

The IT experts at the Veterans Affairs Department have been working hard to ensure that veterans have fast, reliable access to health care services. Their recent innovations include the Blue Button system, which enables veterans to download their personal health records; Fast Track, which is reducing the backlog of claims related to Agent Orange exposure for Vietnam era veterans; and a VA/Defense Department initiative for creating a shared electronic health record for service members from active duty through veteran status. Although many people worked on those and other projects, Deputy Secretary W. Scott Gould, who functions as VA’s chief operating officer, is credited with providing the vision and leadership that made their success possible.

The three strategic goals we have at VA really break down to: [first] increasing access for veterans to health care and benefits; second, making sure we're eliminating the claims backlog; and finally, eliminating veterans' homelessness by 2015. Big, bold, hard-to-do goals that are specific, time-phased and measurable. Technology is one of the enablers that we have to address those goals.

To date, we have had 750,000 downloads of Blue Button [records], and we have private-sector partners that are taking this on in a big way. We think we're going to be able to have almost 50 million with access to Blue Button inside another year or two. That to us is a great example of how innovation in government can benefit everyone.We employed a soft launch that allowed us to get real experience from potential users early in the process. Design it, build it, implement it, then go public about it — that was the theory and approach we used. Very rapidly, the rates of adoption in government and the private sector began to exceed our expectations.

We wanted to liberate the data, put it in the hands of the patients, let them control it. Once we had that formula in place, we were in a situation where we were increasingly confident that adoption would occur, and that's exactly what's happening.

[For Fast Track], we realized that we were going to face a tidal wave of claims that we needed to clear through the system. This would have been challenging without there already being a situation where we had a large backlog of claims for other things.

We decided we would create [VA's] first automated claims-processing system. The big insurance companies that work in health care have long had automated systems to assist them in that process. We in VA never invested in those systems, unfortunately. We chose a manual course; we kept going on that.

One of the jobs of a chief operating officer is to synchronize all the elements that are required to be able to accomplish the mission. You can see that in this example. We had 20,000 people in our benefits administration [division]. We had the chief technology officer and his team. We had the chief information officer, Roger Baker, and lastly we had the acquisition team having to work through the Federal Acquisition Regulation process to deliver the benefit. My role was to make sure all four of those individuals understood that our success as a team was based on each others' capacity to do their work.

We're on a journey. Our goal is to move as quickly as we can to deliver results for veterans. My only standard of progress is: Did I create more access for veterans to their health care and benefits? Did I eliminate the backlog? And am I ending homelessness? In each of those three areas, we are clearly making measurable progress.

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