The Veterans Administration operates one of the largest consolidated IT organizations supporting over 300,000 VA employees and about 10 million veterans and family members. The information technology 2013 budget proposal includes $3.3 billion for IT which is a $216 million increase over the current budget.
In 2011, DOD and the VA agreed to build the joint Integrated Electronic Health Record (iEHR) and to upgrade EHRs for all veterans to a single common platform. The iEHR FY 2013 budget request is for $169 million.
In FY 2013, plans are to deliver an iEHR Pharmacy Solution, Identity Management Orders Services, Consults and Referrals, Immunizations, and continue the VistA Open Source Custodial Agent at $5 million per year.
In FY 2011, the VA led the way to cloud computing. So far, the VA has successfully implemented a large scale, cloud program in the Post 9/11 GI Bill IT System. In addition, the VA has aggressively adopted the Data Center Consolidation concept to increase systems reliability, security, and to reduce costs.
So that the VA and other agencies can move forward with cloud computing, GSA recently released the Concept of Operations” (CONOPS) document. The plan is for the Federal Risk and Authorization Management Program referred to as FedRAMP to make it possible to initiate new cloud certification programs.
The Office of Telehealth Services, within the VHA’s Office of Patient Care Services has implemented a large national telehealth program within VHA. The goal is to help improve and provide teleconsultations, teleretinal imaging, telemedicine, and telehealth to more rural areas.
To aggressively help veterans in rural areas, Representative Kathleen Hochul (D-NY), on February 14th introduced the “Veterans Telehealth & Telemedicine Improvement Act”. The legislation if passed would improve and expand the VA’s telehealth initiative and further provide veterans in rural areas with easier access to medical care.
The VA’s Office of IT (OIT) in their Acquisition Strategy & Business Relations Office has formed a strategic partnership with the VA’s Technology Acquisition Center to do the following.
• Provide acquisition program management oversight
• Serve as industry liaison
• Provide customer interface support
• Disseminate department-wide IT acquisition policies and procedures
• Monitor OIT federal interagency agreements
• Lead strategic sourcing initiatives
OIT is working across government agencies to unite buying power, provide for integration, consolidate requirements, and implement strategic sourcing initiatives. OIT’s activities also include managing the “Transformation Twenty-One Technology” (T4) contract.
OIT is taking part in GSAs Federal Strategic Sourcing Initiative to provide access to common procurement opportunities that can offer greater discounts, offer business intelligence, and best practice solutions. In addition, OIT is consolidating contracts and creating enterprise licensing agreements to improve the acquisition process.
The VA’s new Health Informatics Initiative (hi2) with a budget request of $8 million will work with the VHA’s transition from a medical model of care to a patient-centered model of care and help to build a sustainable collaborative relationship between VHA and OIT.
The hi2 initiative will work to establish cross-cutting health informatics tools. The schedule for hi2 deliverables will be to deliver products throughout each year for over a period of three years. The Health Informatics team will coordinate with the Virtual Lifetime Electronic Record (VLER), iEHR, and work with teams centered on developing new models of care for the VA.
The goal for the hi2 initiative is to work on internal well coordinated collaborations that will:
• Support rapid product development and delivery methods
• Integrate health informatics and IT in the delivery of healthcare IT products by using a succession plan to transition the Computerized Patient Record System to the next generation of browser-based EHRs
• Build health informatics capacity and develop the health informatics workforce
AVIVA is the VA’s next generation web-based EHR. In FY 2011 two AVIVA software modules were developed with the first AVIVA pilot site launched. Since then, the 3rd and 4th AVIVA software modules have been developed, the first AVIVA prototype module for the system facing interface were delivered, and the Intranet Portal strategy was designed. The FY 2013 budget request includes plans to deploy AVIVA modules to VA medical centers and develop additional modules for the AVIVA framework.
To address the concept of innovation, in 2011, the VA established the VA Innovation Initiative (VAi2) to draw expertise from individuals in government or from outside the government to obtain new ideas to produce innovative solutions to help veterans access services. The VAi2 initiative in FY 2012-2013 will continue implementing projects selected in previous competitions through pilot testing.
In 2012, the VAi2 initiative brought roughly 120 projects into their portfolio which range in size from doctor-lead process improvements costing only a few thousand dollars to multi-million dollar innovations. In addition to continuing to manage and support the VAi2 portfolio, new competitions both internal and external will be announced for 2012 and will be open to industry leaders, start-ups, and non-profits.