The Department of Veterans Affairs will ultimately fix its health system through transparency about the many challenges that the agency is struggling to address, including information technology issues, according to VA Secretary David Shulkin, MD.

Only through openness and honesty about the VA’s myriad problems will the agency be able to find creative and innovative solutions that are effective in transforming veteran healthcare, contends Shulkin.

“I have identified 13 areas of big risk for the VA,” including IT problems, he told an audience on Tuesday at the second annual healthcare and technology VA Innovation Demo Day held at Georgetown University in Washington.

“In information technology, we announced that we’re creating a strategy to move toward a commercial off-the-shelf technology solution—the same one the Department of Defense uses,” Shulkin said.

David Shulkin

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Modernizing the VA’s IT infrastructure and its approach to software development is a top priority, he said. “We’re beginning to update our IT systems,” Shulkin added. “These are decisions, quite frankly, that have been put off for decades.”

In particular, he referenced the fact that “17 years ago, there were blue ribbon panels, congressional hearings and consulting reports saying VA needed to move toward a system that would allow interoperability with DoD and needed to be a more modern system—but, we put that off.”

No longer will the agency delay such important technology decisions, said Shulkin. “When it comes to modernization, we need innovation to help bring our system up into the most advanced technology in ways of serving our veterans.”

According to Shulkin, as difficult as it is, the VA must compete head-to-head with the private sector and convince veterans to make the choice to use the agency’s health services.

“We have to have a product that they want,” he observed. “When veterans choose healthcare, they’re going to choose between going to a VA facility or choosing to go into the private sector. That will fundamentally raise our level of performance. That will make us be more responsive. That means the more that we can give veterans information about quality of care, about the service that we provide, the more we can improve our service so that they will want to choose us.”

Toward that end, the VA recently launched a new online tool to provide patient wait time and quality of care data to veterans in what Shulkin called a first-of-its-kind system. He contended that no other healthcare system in the country releases this type of information.

“We still struggle with access to care and wait times—one of the ways that we innovated on this was we now publish our wait times,” he added. “So, it’s openly transparent for everybody to see on websites exactly where our wait times are for any type of appointment that they want to get. We update that now weekly.”

The internally developed Access and Quality Tool enables veterans to access information such as average wait times for patients to be seen in their local area; descriptions of veterans’ experiences scheduling primary- and specialty-care appointments at specific VA facilities; and quality of care data for VA medical centers, compared to local private-sector hospitals.

The VA will continue to add information on quality of care, satisfaction, as well as nursing home quality information to the platform, according to Shulkin, who concluded that this is the agency’s “primary strategy on timeliness to access.”

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