Wednesday, May 18, 2011

Veterans IT Program

Roger W. Baker, Assistant Secretary for Information and Technology and CIO for the Department of Veterans Affairs appeared before the House Committee on Veterans Affairs on May 11th, to discuss the Veterans Administration’s IT plans and actions.

According to Assistant Secretary Baker, the VA IT enterprise is a massive single, consolidated network with 152 hospitals, 791 CBOCs, and 57 benefits processing offices. With the $3.1 billion FY 2011 budget, the Office of Information and Technology (OI&T) manages a technology profile of over 314,000 desktop computers, 30,000 laptops, 18,000 blackberries and mobile devices, and 448,000 email accounts.

The VA has begun work on the Data Center Consolidation and on cloud computing. For example, the VA has a large-scale cloud program in the Post 9/11 GI Bill along with another program to address the development of the Veterans Benefits Management System in place to break the claims backlog.

Other initiatives include the Blue Button Program to allow veterans to download their personal health information from their My HealtheVet account, and the Pharmacy Reengineering program to replace existing pharmacy software modules.

In addition the VA has adapted a key component of the “Program Management Accountability System” (PMAS). Before the implementation of PMAS, approximately 283 development projects at VA met their milestone dates an estimated 30 percent of the time. Today the VA has 107 active development projects tracked in real-time through a project database and dashboard that meets the milestone dates approximately 75 percent of the time.

The Committee also heard that the VA has achieved full implementation of the medical device isolation architecture which is essential to mitigate security vulnerabilities in medical devices. The isolation architecture enables the VA to localize virus outbreaks in populations where it is very difficult to provide protection for medical devices. This is accomplished by using virtual local area networks and access control lists to enable the VA to identify threats and vulnerabilities plus quarantine them to prevent viruses from spreading across the VA network.

The VA’s Virtual Lifetime Electronic Record (VLER) enables service members, veterans, and caregivers to manage benefits and care from the day they enter military service and throughout their lives. VLER is now being used to support the exchange of healthcare information between DOD, VA, and private healthcare providers in San Diego, Hampton Roads, Richmond, Spokane, and in the Asheville North Carolina area.

By using VLER and further expanding the eBenefits portal, veterans are now able to access their information, including healthcare records, benefit applications, and other personal information through an interactive web portal. The eBenefits portal is rapidly growing with more than 278, registered users as of March 31, 2011.

According to the VA, the current VistA EHR system meets or exceeds the capabilities currently available from commercial EHR vendors. However, low investment in VistA over the last decade has eroded its standing from being the market leader to being merely competitive. While VA clinicians support and prefer VistA as a clinical tool, they also want to see the system updated and improved.

To keep costs, down, the VA has turned to Open Source as a way to produce production quality software. Market leading products such as UNIX, Linux, Netscape, Mozilla, Apache and many others have benefited from the Open Source approach.

So far, the VA has spent more than a year conducting a deliberative process to examine the implications of Open Source for VistA. The VA has studied numerous papers, emails, and comments on the subject and as a result, the VA has issued three RFIs. The current thought is that by using Open Source, innovation will improve and the budget will not increase. Just recently, the VA released an RFP to establish an Open Source “Custodial Agent” position that would run the Open Source community.