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VA’s EHR decision and the future of government

Shutterstock image: digital record management.

There is a lot to like in Veterans Affairs Secretary David Shulkin’s recent decision to combine forces with the Defense Department to establish modernized electronic health records (EHRs) for our nation’s veterans. Hopefully, that path goes beyond being the start of better service for those who have served America so well and so ably through personal sacrifice.

Indeed, it might also be the harbinger of the government of the future.

The cross-agency collaboration that the Department of Veterans Affairs has set in motion is enabled by innovative thinking and new technologies, and it has the potential to provide significant efficiencies in care delivery. Perhaps equally important, VA’s approach provides a person-centric government service model for the future — one that is collaborative, cross-agency, service-oriented and driven by data-based insights.

A collaborative, cross-agency government that is focused on the best possible service to its constituents should be the holy grail for all of us — contractors and government employees — who serve this nation.

Working in lockstep with DOD to modernize the EHR system better enables VA to meet the health care needs of veterans and their families. In addition to improving services, VA’s approach points to future strategies for modernizing its data systems.

The decision also highlights the increasing significance of scalable platforms in delivering emerging technology and capabilities.

Moreover, because the federal government funds much of U.S. health care, VA’s actions point to the potential for health IT and health data analytics to deliver the benefits of standardization, actionable insights and emerging cognitive capabilities to improve health outcomes. Common EHR platforms will enable medical providers and payers to access disparate data sources to understand, reason and learn — the key elements of cognitive systems that allow people to leverage vast data stores with interactive applications that support better decisions.

The Veterans Health Administration pioneered a user-designed EHR embedded in its Veterans Information Systems and Technology Architecture (known as VistA). The platform serves clinicians and patients at a level to which other EHRs aspire. VistA’s user-based design fostered buy-in from clinicians, administrators and other users, including a majority of medical residents trained on the system.

However, lack of adequate governance led to multiple versions of the computerized patient record system, revealing a barrier to seamless exchange among VHA, DOD and purchased-care partners.

Shulkin’s announcement makes a case for modernization that aligns with an integrated, interoperable ecosystem for health data that supports longitudinal records, clinical information sharing, care improvement, cost reduction and better patient experience.

VA can continue to improve management of health data by promoting clinicians’ use of EHRs, which will help reduce barriers to the information sharing that is necessary for cross-organizational health care delivery.

By focusing on integration and interoperability, VA’s announcement creates an opportunity to develop a model solution for national health care data sharing and use. The evolution of a multi-agency ecosystem will yield efficiencies and economies of scale that can transform care delivery across government and with commercial partners.

Indeed, VA’s triple aim of improving population health, increasing patient satisfaction and reducing per-capita health care spending aligns powerfully with DOD’s quadruple aim, which adds clinician satisfaction to the other three goals.

That cross-department coordination around a constituent group, enabled by data-driven insights, should serve as a model for the government of the future.

About the Author

Lisa Mascolo is managing director, IBM U.S. Public Service, in IBM's Global Business Services unit, where her purview spans the U.S. federal government and the state and local government and education markets. Lisa’s “affordable, insightful, essential” approach to the government market is designed to provide high-quality services and solutions that solve problems and address today’s challenges – both for IBM’s clients and their clients.

Before joining IBM in March 2016, Lisa coached senior leaders and provided business strategy consulting services to small and large businesses as the CEO of Listen Learn Lead LLC. Previously, she spent nearly 30 years in leadership roles at Accenture both before and after its transition from private professional services firm to a Fortune 500 public company.

Lisa’s career journey at Accenture, working with some of the company’s largest government clients across the globe, included tenure as group chief executive for the Public Service operating group; as U.S. country managing director, leading the company’s management consulting, systems integration and technology, and outsourcing organizations; and as managing director of Accenture’s U.S. federal business. Post-Accenture, Lisa served as CEO for IT services company Optimos, establishing the company’s brand in the federal marketplace and driving its profitability.

Lisa believes that success is not measured solely on profit and loss, but on client satisfaction and professional development as well. At IBM, she continues to explore and create new benchmarks for quality and success. For more than 30 years, Lisa has been vocal about doing good while doing well, a philosophy espoused in her commitment to many philanthropic endeavors, including the non-profit Quoteablle, K-12 educational nonprofits, veterans and domestic organizations focused on helping disadvantaged women achieve economic independence.

Lisa is a trustee at her alma mater, Stevens Institute of Technology, and serves as chair of the institute’s HR and Compensation Committee. She also serves on the board of governors of the St. Albans School of Public Service and chairs the board of governors’ Advancement Committee at Grace Episcopal Day School. Well-known as a thought leader in the government market, Lisa has extensive media experience and contributes regularly to industry initiatives across many channels.

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