Decision time for scheduling tech at VA

The Department of Veterans Affairs is on deadline to decide whether to test a homegrown scheduling solution for patients.

Shutterstock image: medical professional interacting with a futuristic interface.
 

The Department of Veterans Affairs is on the cusp of a decision that could have broad repercussions on whether the agency pursues a broad strategy of commercializing its technology core, including its homegrown Vista electronic health record system.

The agency is on the hook to tell lawmakers about whether it plans to pursue the testing of an internally developed scheduling product, or proceed with a long-planned commercial acquisition.

Dr. David Shulkin, currently the VA's undersecretary for health and President Donald Trump's pick to lead the agency, told a Senate panel on Feb. 1 that the agency was looking at whether to begin testing the internally developed Vista Scheduling Enhancement, which interfaces with VA's electronic health record system, or go with a commercial solution for which a contract was awarded in 2015.

The VA's scheduling system became enmeshed in a larger controversy, when it was revealed in 2014 that schedulers at the Phoenix medical center kept two sets of books to conceal lengthy wait times for appointments, while appearing to comply with agency regulations. The scheme was abetted by an imprecise logging system in the Vista scheduling module that made it impossible to discern who was responsible for an appointment being scheduled and then changed.

The scheduling scandal changed a lot at VA. It led to the resignation of Eric Shinseki as secretary, and the appointment of Procter and Gamble CEO Bob McDonald to replace him. The new agency head focused on building a veteran-focused VA, with a heavy emphasis on usable technology.

But one thing that hasn't changed is the scheduling system. VA still uses the native Vista application.

"They're using what I would call old blue DOS screens to schedule," Shulkin said at his confirmation hearing. "I don't even know how they do their jobs."

Back in 2014, Steph Warren, then the agency's acting CIO, told a Senate panel that he hoped to have a new system in place by the end of fiscal year 2015. The VA had been taking steps to modernize its scheduling, in part as a result of a critical 2012 Government Accountability Office report on problems with scheduling.

In 2015, VHA picked the leading electronic medical records provider Epic along with Lockheed subsidiary Systems Made Simple for a five-year, $624 million contract for the Medical Appointment Scheduling System program.

MASS was put on hold in April 2016, after developers inside VA said they could supply the needed application at a fraction of the cost of the commercial solution. VSE is an Outlook-style interface that offers schedulers a dashboard view of appointments. The VSE 1.0 is currently in use on a pilot basis to schedule appointments by 46 schedulers at 32 clinics across five test sites, according to a VA spokesperson. If approved for nationwide implementation, VSE 1.1 will go live in the spring at primary care facilities.

MASS implementation stalled out during the VSE pilots, but put back in gear in January 2017. An 18-month pilot is moving ahead in Boise, Idaho. The Epic product contracted under the MASS program would replace the Vista scheduling application and monitor demand for medical care and VA's capacity across the enterprise.

This is further complicated by the coming procurement for a commercial self-scheduling system required under the Faster Cares for Veterans Act of 2016, and an effort to expand the Vista Veterans Access Request self-scheduling module.

The situation has lawmakers somewhat befuddled. Reps. David Roe (R-Tenn.) and Tim Walz (D-Minn.), the chairman and ranking member of the House Veterans Affairs committee, are eager for VA to make a final call in the scheduling decision, and they aren't hiding their preference for a commercial product.

"Suddenly, VA has four similar scheduling programs going at once," Roe and Walz wrote in a Feb. 8 letter to acting CIO Rob Thomas, seeking insight on why they weren't informed about the MASS reboot and looking for more regular progress reports on scheduling efforts.

"Additionally, please explain how these four programs will be managed so that modern scheduling technology can be quickly delivered without creating duplication, and without undermining [the Office of Information and Technology's] preference for existing commercial off-the-shelf solutions.

At a Feb. 7 hearing of the House Veterans Affairs Committee, Thomas told lawmakers, "My goal is to go commercial to the greatest extent possible."

If the VA goes with a commercial product, it could augur more commercialization, including a move off the home-grown Vista electronic health record platform.

"VA needs to let go of Vista and go to a commercial solution," Dave Powner, who works on oversight of VA information technology at the Government Accountability Office, said at the same hearing.

NEXT STORY: In praise of public servants

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.