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FCW : August 30, 2014
After the Veterans Access to Care through Choice, Accountability and Transparency Act passed the House and Senate by overwhelming majori- ties, President Barack Obama signed it into law on Aug. 7. The law requires outside review of almost every aspect of the Department of Veterans Affairs operations, includ- ing "the competency of leadership with respect to culture, accountability...and performance management." Scattered through the bill are also a number of speci c IT and management mandates for the department, many of which could entail signi cant new systems. Key provisions include: 1. Digital waiting list. VA must cre- ate an electronic waiting list that will allow veterans to monitor their posi- tions in line and view the average wait times for each facility and type of care. The wait-time information must also be available online to the general public. 2. Claims-processing system. Many veterans will now be able to go outside VA for covered care, so the department must develop an "ef cient nationwide system for processing and paying bills and claims for authorized care." Regulations for the system must be drafted within 90 days of the law being enacted. 3. Electronic medical records. EMRs have been vital to VA s health efforts for years. The department must now coordinate with external health care providers to ensure that data is fed back into veterans personal records. 4. VA Choice Cards. VA will have 90 days to establish a system to moni- tor and issue Veterans Choice Cards that will facilitate care from non-VA providers. 5. Electronic noti cations. Veterans must be noti ed electronically --- if that is deemed to be the most effective means --- about the care or services they are eligible to receive. 6. Telemedicine. VA has been a leader in telemedicine, but the department must now ensure that every mobile medical center is capable of providing telemedicine services. 7. Open data. Data on patient safety, quality of care and outcomes must be published as a comprehensive database within 180 days of the law being enact- ed. That data must then be fed into the Department of Health and Human Services Hospital Compare website. 8. Off-the-shelf solutions rst. The VA s history of developing in-house solutions has also been targeted for special scrutiny. The law calls for care- ful review of "any interim technology changes or attempts...to internally develop a long-term scheduling [solu- tion] with respect to the feasibility and cost effectiveness...compared to com- mercially available solutions." 9. Outside assessment of IT sys- tems and work ows. VA must con- tract with an external assessor to review the systems and work ows used for scheduling, staf ng, length- of-care management and documenta- tion of care. The external review must also cover the department s core IT strategies for furnishing and manag- ing care, "including an identi cation of any weaknesses and opportunities with respect to the technology used." 10. Better access control. An addi- tional assessment will explore wheth- er system access should be limited to employees who have been "properly trained" in scheduling appointments. 11. Technology task force. Newly con rmed Secretary Robert McDon- ald has been instructed to establish a technology task force that will review the department s scheduling systems and software needs. 12. Bonuses. Bonuses based on scheduling and wait-time metrics are abolished, and any future falsi cations of data concerning wait times will meet with serious penalties, up to and including dismissal. McDonald must also ensure that annual awards and bonuses do not exceed $360 million. 13. Executive performance. The secretary will be given expanded power to remove VA executives for poor performance and must report any such dismissal to Congress within 30 days. ■ A new secretary and recently signed reform legislation mean the Department of Veterans Affairs' IT and management practices face some big revisions 13 things that are about to change at VA BY JONATHAN LUTTON AND TROY K. SCHNEIDER DrillDown 30 August 30, 2014 FCW.COM
September 15, 2014
August 15, 2014