STEPHEN M. LUCAS
DIRECTOR, TAMPA VAMC
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
SENATE COMMITTEE ON VETERANS' AFFAIRS
CURRENT STATE OF AFFAIRS FOR INFORMATION TECHNOLOGY
WITHIN VHA MEDICAL CENTERS
SEPTEMBER 19, 2007
Thank you Chairman Akaka and members of the Committee. I am pleased to have this opportunity to appear before this Committee as a proud and long time employee of the Veterans Health Administration (VHA). Today I would like to discuss my personal knowledge and experience with the realignment of the Department of Veterans Affairs (VA) Office of Information and Technology (OI&T). I wanted to first take a moment to review the reorganization process. I will then follow with some personal observations on what I think has worked, and what I think needs to be watched closely to ensure that we improve the effectiveness of the newly revised IT organization.
I would also like to state upfront as a personal observation, that VistA is a system put together by clinicians for clinicians and it works, still works, and no one who uses it, ever wants to go back to what they had, or in many cases, didn't have. We should never lose sight that VA's VistA system remains a world class system and the Industry Standard for Electronic Health Records (EHRs) by a long shot.
In March, 2006, Secretary Nicholson approved a new business model as the framework for VA's IT System. This generated the initial realignment to OI&T in the neighborhood of 6,000 Operations and Maintenance personnel who were previously part of VHA, the Veterans Benefit Administration (VBA), National Cemetery Administration (NCA) and other parts of VA. On October 31, 2006, Secretary Nicholson approved the transition of the VA IT Management System for the Department of Veterans Affairs (VA) to a single IT leadership authority - the VA Chief Information Officer (VA CIO). This included the permanent assignment of all VA personnel dedicated to IT development, approximately 1,000 personnel, to the Office of the Assistant Secretary for Information Technology (AS/IT) to be completed by April 2007. The final transition and realignment, to include institution of a governance structure, clear understanding of roles and responsibilities, establishment of standardized policies and business practices, etc., was directed to be completed by the Secretary by June 2008. This transition is significant due to the large numbers of people transitioned, many new polices and business processes having to be evaluated and implemented, and new communication paths and operating procedures tried, rejected in some cases, restructured and then re-implemented. All the while, caring for our patients has remained our primary mission.
I will certainly not try to hide the fact that the realignment, due to its magnitude, has created some distractions, as well as anxieties in VHA's medical community. Specifically, at Tampa, we were concerned that we would lose the authority to make the necessary medical decisions at the point of care and that, by the transfer of our development team to OI&T, we would lose our ability to "innovate" - the very engine that created the World Class VistA system in the first place. Thus far, those fears have not proven true and more importantly, we have not lost sight of our first priority to provide the highest quality care to our veteran patients, the men and women who deserve no less given the sacrifices they have made for our Nation.
What is working?
What needs to be closely watched as we move forward?
And why is all of this so critical? VA has made significant progress in the evolution of its IT systems and we must continue to foster an environment where we can continue to do so in the future. The original VA IT health care system was hospital-centric, meaning it focused primarily on establishing over 100 applications at specific care locations. The needs of VA patients require a patient-centric approach, which will allow veterans and their care providers to access seamless health records and information at any time regardless of location. And so it is important that VHA and OI&T continue to work together to ensure we have a system in the future that:
Let me conclude by saying that the realignment was not without its challenges, but I see a spirit of cooperation and mutual objectives that will allow us to overcome them as we continue to remain the world's leader and benchmark for health care delivery. I am also proud to say today that, despite all of the natural and expected distraction that occur in a major realignment, we are still serving the veteran with quality care, and I only expect it to get better as we continue to improve the process and work towards better communication and cooperation.
Mr. Chairman, this concludes my statement. I will be pleased to answer any questions that you or other members of the Committee might have.
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