Management

What's wrong with IT at Veterans Affairs?

Projects are stalled, and top leaders have departed. Investigations and agency sources paint a bleak picture inside VA's IT office.

The agency charged with providing health care to America's veterans seems to be paralyzed itself by information technology failures and high-level departures. (Stock image)

The Department of Veterans Affairs has been on the hot seat in recent months over its backlog of compensation claims and slow progress on an expensive joint health records system with the Defense Department. Both projects have significant IT components, but multiple assessments suggest that VA's Office of Information and Technology (OIT) is ill-equipped to deal with the problems.

Formal reports include a "deep dive" internal review of OIT by Deloitte that was completed in December but not released to the public, and several Government Accountability Office and VA Office of Inspector General investigations. FCW also interviewed a dozen current and former VA officials, several of whom spoke on condition of anonymity.

Combined, the information reveals dysfunction at the highest echelons of the VA OIT: botched and duplicative IT projects burning through billions of dollars, significant turnover among senior IT executives, a lack of official accountability, and a serious disconnect between rank-and-file employees and OIT leaders.

Big project problems

VA's backlog of veterans' disability claims is a black eye for the department by any measure. According to VA figures dated April 20, the number of claims pending for more than 125 days was 613,469, while the total number of pension and entitlement claims was 886,345. In recent months, lawmakers on Capitol Hill, GAO and veterans' groups have condemned the bottlenecks, which VA Secretary Eric Shinseki has repeatedly said are a top priority.

"For years, VA has struggled with an increasing workload of disability compensation claims," a December 2012 GAO report states. The department is "currently taking steps to improve the timeliness of claims and appeals processing; however, prospects for improvement remain uncertain."

In his April testimony on the fiscal 2014 budget proposal, Shinseki said his agency "remains focused on eliminating the disability claims backlog in 2015 and processing all claims within 125 days at a 98 percent accuracy level."

Even larger questions surround the joint health records effort between VA and DOD. The White House's proposed budget for fiscal 2014 seeks $344 million for the Integrated Electronic Health Record (iEHR) program, which includes $252 million for development via the VA/DOD Interagency Program Office.

The iEHR program is designed to achieve a single, integrated platform for sharing health information between the two largest federal agencies, but it stalled in February following a shift in strategy announced by Shinseki and then-Defense Secretary Leon Panetta. Shinseki testified before Congress that VA would move forward with iEHR, but Pentagon officials said they are reviewing their approach.

In testimony on the fiscal 2014 budget proposal, VA Secretary Eric Shinseki said his agency "remains focused on eliminating the disability claims backlog in 2015." Two-thirds of the Senate has written to President Obama asking him to intervene.

"Until I get my arms around this, I'm not going to spend any more money on this," Defense Secretary Chuck Hagel told lawmakers on April 16.

One of the biggest issues is DOD's reluctance to use VA's Veterans Health Information Systems and Technology Architecture as iEHR's core IT platform. VistA is an internally developed system that dates back to the 1980s. However, DOD also wants to do away with its own system, called AHLTA. DOD was set to release a request for proposals for a replacement in March, but Hagel halted the RFP pending further review.

The problems with the iEHR program -- already a failure to some -- did not come as a surprise to VA insiders, who believe their agency attempted to talk the talk with DOD but could not afford to walk the walk.

"The iEHR demise was expected by all, accordingly," one VA source said. DOD officials "outspend, outtalk and outlast us at every engagement. We try to emulate much of their process-based decision-making as if we could afford to. We can't. The overhead is crippling, and we are not funded equivalently."

Org chart challenges

The problems with those programs go beyond IT, but both show signs of the organizational challenges that have been identified elsewhere. The December 2012 Deloitte report, reportedly commissioned by acting assistant secretary for information and technology and acting CIO Stephen Warren, found several trouble zones in VA's OIT. Among them are a disconnect between facility staff and leadership, low data quality, a poor organizational structure that leads to inefficient resource deployment, duplicative functions across multiple organizational pillars, no standardized processes or supporting technology, a lack of customer understanding of how OIT works, and the fact that many OIT organizations are not measuring the right metrics.