What's wrong with IT at Veterans Affairs?

Frank Konkel | FCW | May 1, 2013

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

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...


Centralization vs. Decentralization of Health IT

From the 1980's thru 2000 the VA made tremendous progress in building and deploying VistA, one of the best electronic health record (EHR) systems in the world. Responsibility for the system rested in the Veterans Health Administration (VHA), the business unit directly responsible for providing healthcare to our nation's veterans. Then Congress ordered the VA to centralize responsibility for IT and moved the healthcare systems under the Office of Information Technology, a unit managed by people who had no responsibility or knowledge of healthcare or the VistA system. It would probably have made much more sense to centralize selected functions like IT policy, procurement contracts, and IT security under OIT, rather than also shifting development and day-to-day operation of health IT systems under them. A lot of momentum was lost in that move from a proven and effective decentralized organizational structure to a less effective, more highly centralized organization. It is well understood that having the wrong organizational structure in place can severely hamper an organization's effectiveness. - Peter Groen, Senior Editor, OHNews