VA takes two-pronged approach to deploy appointment software

Agency to install internally developed system while piloting commercial solution, says David Shulkin, MD.


The Department of Veterans Affairs is pursuing the use of a self-developed scheduling application as an “intermediate stop-gap measure” until the agency is ready to roll out the new commercial Medical Appointment Scheduling System (MASS) across all its facilities.

The VA originally was supposed to replace its antiquated system for managing medical appointments with commercial off-the-shelf software by this year.

Last week, during a congressional hearing, VA Secretary David Shulkin, MD, defended the agency’s dual-track modernization approach of investing in two scheduling systems simultaneously.

“On the surface, I grant you this makes no sense at all,” Shulkin told members of Congress. “We awarded a commercial off-the-shelf product called MASS. That is the system that we think meets our solutions, and that’s the one that we’re implementing. We’re working right now on a pilot site to be able to create the interfaces so that we can do that.”

Nonetheless, Shulkin informed House appropriators that the implementation of MASS across a healthcare system as large as the VA’s will take several years. In the meantime, he said the agency has “developed an internal system—one of the, frankly, last I hope that we ever develop.”

The homegrown system, called the VistA Scheduling Enhancement (VSE), was successfully evaluated in February and has been installed at eight VA sites, according to Shulkin.

“It is much better than what we have right now,” he told lawmakers. “So, as an intermediate stop-gap measure, we’re rolling it out across the country because it’s already been developed and it will help in that intermediate period of time until we can get a commercial off-the-shelf system up.”

While VSE has been approved for national release, the VA has not made a final decision to roll out MASS nationally at this point. After the pilot is complete at the VA’s Chalmers P. Wylie Ambulatory Care Center in Columbus, Ohio, a determination will be made on the next steps, according to an agency spokesperson.

The future of MASS has been uncertain since the VA’s leadership decided in late 2015 to put a hold on implementing the commercial software. “One issue was cost of national implementation,” said the spokesperson.

Also See: VA puts brakes on contract for medical appointment scheduling system

In August 2015, the VA awarded Lockheed Martin’s Systems Made Simple a MASS contract valued at $624 million for a “best-of-breed, proven and mature” commercial off-the-shelf medical scheduling solution. By contrast, the VA’s interim VSE system cost about $8.5 million to develop internally at the agency.

Systems Made Simple partnered with electronic health record vendor Epic to leverage their scheduling software for the MASS contract. The acquisition strategy was meant to fix the VA’s inability to provide timely healthcare to veterans because its facilities use an antiquated system that botched appointments.

The initial MASS task order was completed in December 2015. “After a pause of approximately one year, task order No. 2 is currently under active development,” said a VA spokesperson. “Work will actively begin at the (Columbus, Ohio) site after task order No. 2 is awarded.”

In the meantime, VSE is planned to be deployed to all VA sites, except the MASS pilot site in Columbus and another site in Indianapolis, and will begin implementation in primary care in the third quarter of this year.

Leidos, the parent company of Systems Made Simple, declined to comment on the MASS contract and instead deferred questions to the VA. Systems Made Simple became part of Leidos in 2016 when it acquired Lockheed Martin’s information systems and global solutions business.

Epic was not immediately available for comment regarding MASS.

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