VA secretary touts department's telework, telehealth efforts

Department of Veterans Affairs Secretary Robert Wilkie told reporters July 7 that the VA will look at employee satisfaction on telework as it evaluates whether to allow more employees to work remotely long term, but it will almost certainly keep the capability to provide mental health services online.

“What I have seen is that people have been very happy for the most part with telework,” Wilkie said during a Defense Writers Group virtual event. “We have not seen any drawdown in terms of productivity; I think in many cases it’s gone up.”

“On the medical front,” he added, “there’s no question in my mind that this is the way of the future, particularly in mental health and particularly in terms of expanding our footprint in the most rural areas of our country.”

The VA went from 40,000 monthly mental telehealth appointments to more than 900,000 over the course of the pandemic. The department, which has been moving to expand its telehealth offerings, is also looking at implementing telehealth facilities in WalMart stores “to get into places we don’t normally go.”

Wilkie said the department is still gathering data on its various COVID-19 adaptations, but praised the results he'd seen so far.  “Both for employees and for our patients, telehealth, telework is the way of the future,” he said.  “I think the rest of the government should take a look at what we do.”

EHR implementation progress

Wilkie also said the VA is looking at resuming the rollout of its electronic health records (EHR) system in the Pacific Northwest later this year to improve communications with the Department of Defense.

The news comes after Wilkie told Congress that implementation plans for the Cerner Millennium software-based system at Mann-Grandstaff VA Medical Center in Spokane, Wash., would be delayed after testing found that more time was needed to build the system and properly train clinicians earlier this year.

Resources for IT infrastructure have been integral in the EHR system rollout. As such, the VA could get $2.6 billion to continue implementing the health records system -- a $1.1 billion increase over fiscal 2020 levels, according to the House Appropriations Committee's released bill for fiscal 2021 for military construction, veterans affairs and related agencies’ appropriations. The department had been looking for such an increase to modernize its infrastructure and improve connectivity.

More than two-thirds of that amount, $1.85 billion, is designated for emergency requirements, and funds would be available until Sept. 30, 2023.

Additionally, the House appropriations subcommittee mark allows for $12.5 billion in emergency funding to cover IT systems ($4.9 billion), medical services and facilities, community care as well as medical support and compliance. The subcommittee advanced the bill on July 6.

Higher pay at VA -- but only for certain roles

VA wants to pay medical workers more competitive salaries to better attract and retain them during the pandemic, Wilkie said, and Congress just gave the agency more authority to do it.

“We have to attract doctors and nurses who we are competing with the private sector on,” he said. “We’ve thrown away the book on hiring. In the last seven weeks we’ve hired over 18,000 [providers]; 90% of those are permanent. Almost 5,000 are nurses.”

Wilkie said he was happy about the pace of hiring, but “we have to be realistic. There are certain medical skills we can’t attract unless we have that ability to compensate those professionals.”

The newly passed law allows the VA secretary to lift salary caps for certain high-level employees and officials -- including qualified physicians, dentists, clinicians, medical and pharmacy directors -- beyond the basic pay scale. Certain executive positions, such as the VA’s deputy undersecretary for health, are also covered in the law.

But pay flexibility is only part of the issue. Wilkie said shortening the hiring process, which would often take a year or more, has also been important to improving the VA’s operations.

“We’ve done away with the process that required almost a year of onboarding for doctors and nurses ... the old OPM ways of doing business based on an industrial aged model does not suit us,” Wilkie said. “That was something that we wanted and, in addition to us reforming the way we hire, I think it’s going to make the VA much healthier.”