VA backlog resolution hinges on IT

Amid criticisms of the veteran claims backlog that has mounted through more than 10 years at war, increasingly complex injuries and increased outreach efforts, officials at the Veterans' Affairs Department are looking to technology as a crucial part of a transformation plan to modernize the agency.

IT is playing a critical role as the VA works to bring its systems – particularly those dealing with medical records, benefits and compensation claims – into a comprehensive, paperless operation fit for the new millennium. It has not been an easy road, as illustrated by Congress and the watchdog agencies that have rapped the VA for its records management lapses. But according to VA officials, there is hope in the form of new systems that improve access, automate processes and streamline services.

"To serve veterans as well as they have served us, we are working on delivering a 21st century VA that provides medical care, benefits and services through a digital infrastructure. Technology is integrated with everything we do for veterans," VA Secretary Eric Shinseki said in April 15 testimony before the Senate Veterans Affairs Committee. "Advances in technology – and the adoption of and reliance on IT in our daily commercial life – have been dramatic."

The VA's proposed budget for fiscal 2014 includes some $3.7 billion for IT, an increase of $359 million from the president's 2013 budget. Of that, $291 million directly targets the backlog through programs like the Veterans Benefits Management System (VBMS), set to receive $155 million, and the Veterans Relationship Management (VRM) initiative, slated for $120 million.

The idea is that these programs will not only speed up processes by digitizing an outdated, paper-based system, but also will strengthen the limitations of what has become a politically charged operation.

"We understand vets' frustration with the time it takes to process claims – you have to consider that [the backlog] is based on patchwork quilt of policy decisions, court decisions and legislation that makes up the disability compensation system we have today," said VA spokesman Steve Westerfeld. "What we do have control over is how we train people, the standards we set to do their jobs with quality and accuracy, and looking at the processes we use and making them as efficient as possible."

The idea of 'people, processes and technology' is a theme in the VA's efforts as the agency transitions to a digital environment and improves access to services and benefits, including through online portals and call centers.

"Our vision is a seamless and secure way... to provide veterans with information that is accurate and efficient and streamlined," said Maureen Ellenberger, director of the VRM program at the VA. "We're about removing the walls and the barriers, letting the veterans have access to their information and providing easy ways to interface with us."

According to Ellenberger, the VA is making significant strides as it continues to build on its IT offerings. For 15 straight quarters the agency has introduced new pieces of functionality, she said.

Among those are features that, in ways similar to smart phone or web-based apps that most people are familiar with, allow secure access and present data pulled from numerous legacy back-end systems, she noted.

"We've now taken away the complexity of those systems and given a view of data that is very consumer-oriented," Ellenberger said. "Allowing veterans to see their records isn't privilege, it's right, so we're about giving them access and the opportunity to understand not only where we are in claims process...but the status questions that [comprise] 60 percent of our call center inquiries. How can we provide that in way that is fair and accurate?"

While the access and information may be streamlined, what's happening behind the curtain is anything but simple. Integrating those legacy systems, tackling identity and access management, addressing cloud and cybersecurity issues – all happening with a team of experts in place – must be done in a way that connects the myriad people and organizations involved. Chief among them: the 56 regional offices that must process the backlog of 592,222 claims pending for more than 125 days.

The backlog is compounded by a 200 percent increase in the number of medical issues reported in each claim, VA officials said.  Each medical issue requires its own documentation and must be investigated -- requiring still more coordination among different corners of the VA system. 

"We're looking at ways to directly connect to [different] levels of systems, to have the same information and quickly share that without putting anything in mail – you just hit the submit button. That's where we fit," Ellenberger said.

According to Westerfeld, the VA remains trained on Shinseki's overall goal: eliminating the disability claims backlog by 2015 and processing all claims within 125 days at a 98-percent accuracy level. As the agency ramps up investment in and development of the IT programs on which that goal hinges, the efforts are still in the early stages but already showing promise, he indicated.

"In artillery you shoot a cannon and there is a lag time before you see when it hits; then you verify that it hit and whether it hit the target, and you make adjustments," Westerfeld said, recounting Shinseki's view of the VA's mission to eliminate the backlog. "We're just in beginning of shooting cannon, and we're waiting to see where hits so we can adjust, verify and refine what we're doing. That's the whole claims transformation as he sees it."