Acting Veteran Affairs Secretary Sloan Gibson assured Congress last week that the VA is working hard to replace its “antiquated” scheduling system, but the Obama administration first received clear notice more than five years ago about the need for an overhaul to reduce patient wait times.
“Excessive wait times are addressed by moving to a resource-based management system,” Veterans Affairs technology officials told the Obama-Biden transition team in a briefing report that included mention of VA’s “schedule replacement” project.
The Washington Times obtained the report through the Freedom of Information Act.
More than five years later, VA officials are hard pressed to explain their lack of progress.
It has taken the still-unfolding VA scandal into manipulated patient wait times — a metric the VA has used to award executive bonuses — to shine a light on the failings of the current system, which Mr. Gibson called “outdated” in recent congressional testimony.
“VA has been trying — and failing — to replace its outpatient scheduling system since 2000, wasting nearly $130 million in the process,” Rep. Jeff Miller, Florida Republican and chairman of the House Committee on Veterans’ Affairs, told The Times when asked about the delays.
“Because VA acquisition officials have proven time and again they are simply too inept to guide the development of a new proprietary appointment-scheduling system in an expedient and cost-effective manner, department leaders need to look at adopting commercial technologies that are being used in the private sector,” Mr. Miller said.
VA officials declined to respond to multiple inquiries last week concerning the lack of progress on the scheduling system.
The project has spanned administrations. The briefing papers sent to the Obama transition team in 2008 noted that “application development” on the schedule replacement project already had been underway for six years.
“VA is taking a phased approach to implement the application, as the move from a 25-year-old legacy system to a new infrastructure is understandably complex,” VA officials told the incoming administration.
The briefing papers said a scheduling replacement would address excessive wait times and allow clinicians to view all patient history information across the VA.
By contrast, the current appointment system “is rigid and lacks efficiency,” IT officials noted. “Providers must maintain multiple calendars for clinical activities, extended hours or slots needed for special circumstances, such as compensation and pension examinations.”
Beyond the scheduling system, VA’s technology office also disclosed other major technology challenges across VA to the incoming administration, including serious deficiencies in the agency’s IT workforce.
“IT skill gaps, at all levels, include poor communication, change management and basic supervisory skills,” VA officials wrote.
The overall IT infrastructure is “comprised of a loose confederation of independently chosen elements without a comprehensive system engineering or architectural plan, clear standards or rigorous IT management processes,” officials wrote.
And officials said infrastructure-building issues in many VA facilities were “negatively impacting” performance of IT equipment, citing a 2008 incident at a medical center in Nashville where IT outages spanning three days left officials unable to access electronic health records.
He said the agency recently held an “industry day” to get a better idea of what to include in its upcoming scheduling solicitation. He didn’t mention a firm date, but VA has told contractors a solicitation for its MASS procurement — medical appointment scheduling system — should be released sometime later this summer, according to procurement records.
Still, there are many unanswered questions.
VA hasn’t decided on an acquisition strategy, nor have officials told contractors how the new system’s deployment might affect current union agreements, according to procurement records. The VA also hasn’t decided on any hard deadlines.
Joel C. Willemssen, managing director for information technology at the Government Accountability Office, told a House panel on Wednesday that work on VA’s schedule replacement project actually began in 2000.
Despite spending $127 million over nine years, VA hadn’t “implemented any of the planned capabilities,” Mr. Willemssen testified.
Data reliability was an early problem, he said. The scheduling project started providing monthly reports to the VA’s chief information officer in 2006, but the information contained contradictory information about performance.
There’s no price tag on the new scheduling system, but it’s a massive procurement that’s attracted interest from big contractors such as Booz Allen Hamilton, CACI International, IBM, Microsoft and GE Healthcare, among others, procurement records show.