House panel rips VA leadership on scheduling software pause

Lawmakers seeking answers on shifting Department of Veteran Affairs plans to modernize scheduling software came away skeptical with the answers they received from top officials at an April 14 hearing.

VA Undersecretary for Health David Shulkin, Assistant Secretary for Information and Technology and CIO LaVerne Council and Assistant Deputy CIO for Project Management Alan Constantian appeared before the House Veterans' Affairs Committee's Oversight and Investigations Subcommittee.  They outlined VA plans to pause development on the Medical Appointment Scheduling System (MASS) and instead stick with scheduling solutions developed in-house -- a reversal of plans the agency announced in the wake of its scheduling scandals.

"Recently, VA determined that the [VistA Scheduling Enhancement and Veteran Appointment Request systems] appear to meet its scheduling needs, and MASS is unnecessary," Rep. Mike Coffman (R-Colo.), who chairs the oversight subcommittee, said at the hearing. "This decision is a dramatic about-face. It means sticking with the government-developed technology indefinitely."

"MASS has been stopped before even its first pilot could be compared with VSE and VAR," Coffman added. "The plan was to see which solution works best. It seems we will never know."

Currently, both VAR and VSE are being run through pilot programs, the VA officials said. VAR, which lets veterans customize and request their appointment dates, is being tested at two facilities,  while VSE, which focuses on improving the existing scheduling system's user interface, is in use at 10 locations. The enhancements are intended to speed the scheduling process and cut down on scheduling errors.

MASS is being put on a "strategic hold," Shulkin said, the pilot alone for that program would cost $152 million for testing on three sites, and would take 10 months. VSE, he said, will cost just $6.4 million for the full rollout nationally, and is expected to finish in the next couple of months. If the home-grown solutions do not fulfil veterans' needs, then VA will come back to MASS, Shulkin said

Rep. Dan Benishek (R-Mich.) was unimpressed.  "Too often IT projects have progressed to a critical decision point and then been abandoned in favor of another initiative or another plan," he noted. "VA must realize that maintaining manual systems -- and deferring to archaic operating systems as the default -- cannot continue." 

Skulkin stressed that MASS had not been abandoned.  "We did not cancel it at all," he said. "It is a contract we can execute at any time." He told lawmakers the decision would be revisited once the VSE rollout was completed.

Rep. Ann McLane Kuster (D-N.H.), however, noted that the agency has wasted nine years and $127 million on the scheduling system without any success. "This seems like deja vu all over again to me," she said. "We cannot and will not let this happen again. ... You need to understand that Congress cannot continue to give VA a blank check to spend on IT projects."

MASS is not the only program being put on hold.

The planned modernization of VistA is also being re-evaluated, the VA officials said, and the possibility exists that the agency might purchase a commercial off-the-shelf product for its electronic health record system.

Just this week, House appropriators backed $168 million for the VistA Evolution project in an agency wide funding bill. That figure responds to an administrative request for a reduction in funding while the VA considers all its options with regard to the future of its EHR system. This legislation also fences off funding for VistA modernization pending receipt of information from VA about its business case analysis of EHR systems and other documents detailing the agency's strategic plan for electronic health records.

Both House and Senate appropriators remain concerned about interoperability between VistA and DOD's current health record systems, as well as with the planned DOD-wide system that is scheduled to begin testing later this year.