Major Initiatives by wanghonghx


									                                                                                  Part I – Major Initiatives

Major Initiatives
VA has identified 16 major initiatives that will serve as a platform to transform VA into a 21st century
organization that is people centric, results-driven, and forward-looking. Provided below are tables for
each of the initiatives showing the problem being addressed and a summary of FY 2010 actions and

      Problem Being Addressed                                FY 2010 Actions and Progress
     Single male Veterans are                 In FY 2010, more than 132,000 unique Veterans have been served
      disproportionally represented             in VA’s continuum of homeless programs.
      among the homeless population.           Beginning in 2010, VA’s Five Year Plan to End Homelessness
      Based on 2009 data, approximately         Among Veterans began assisting every eligible homeless or at-risk
      13 percent of the homeless                Veteran willing to accept services. The plan focuses on the
      population are Veterans.                  prevention of homelessness, permanent supportive housing,
     Current population estimates              mental health and substance abuse treatment, and access to
      suggest that about 107,000 male           benefits education and employment assistance.
      and female Veterans are homeless         An estimated $534 million will be spent in direct support of
      at any given time and perhaps up          homeless Veterans; $2.9 billion will be spent in health care
      to twice as many experience               treatment cost in 2010 for homeless Veterans.
      homelessness at some point during        In December 2009, VA launched the National Call Center for
      the course of a year.(*)                  Homeless Veterans (NCCHV). The call center number is 1-877-
                                                -   As of September 30, 2010, almost 13,000 calls have been
                                                    received by the NCCHV resulting in 5,500 referrals to medical
                                               As of September 30, 2010, VA housed more than 18,000 Veterans
                                                through the HUD-VASH Program since Congress reinstated the
                                                program in October 2008.
                                               VA’s work programs provide paid work experience and vocational
                                                assistance services to approximately 50,000 Veterans each year,
                                                including 6,000 Operation Enduring Freedom/Operation Iraqi
                                                Freedom (OEF/OIF) Veterans. These services are integrated into
                                                the Veteran’s overall mental health treatment plan.

    (*) Accurately counting and/or calculating the number of homeless Veterans in the United States is
    understandably difficult. The homeless are usually mobile, generally cannot be contacted by phone or mail
    and may not be willing to participate in surveys or avail themselves to other data gathering efforts.
    Based on a recent U.S. Department of Housing and Urban Development (HUD) report submitted to Congress,
    homeless Veterans make up approximately 19 percent of all homeless adults who accessed emergency shelters
    or transitional housing in communities across the United States.
    Many other Veterans are considered near homeless or at risk because of their poverty, lack of support from
    family and friends, and dismal living conditions in cheap hotels or in overcrowded or substandard housing.

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                        (PRIORITY GOAL)
          Problem Being Addressed                            FY 2010 Actions and Progress
         Currently, the average disability     VA is implementing a 21st Century paperless claims
          claims processing time is 160         processing system - the Veterans Benefits Management
          days. Veterans and survivors          System (VBMS).
          waiting to receive decisions on
          their compensation and pension
          claims need timely decisions          Actions and progress made during FY 2010 on VBMS are
          because they rely on VA benefits      cited below:
          that they earned through their
                                                   Completion of the Virtual Regional Office: Resulted in
          military service.
                                                    system specification and business requirements for
         Reducing the length of time it            development and rating work.
          takes to process compensation
          and pension rating-related claims
          is an integral part of VA’s mission      Established VBMS Program Management Office:
          to serve Veterans by providing all        VBMS PMO authorized; comprised of VBA and OI&T
          possible benefits under the law to        resources.
          eligible claimants in a timely,
          accurate, and compassionate
          manner.                                  Developed Business Requirements: Documented
                                                    VBMS’s business requirements for Pilot 1 deployment.
         VA seeks to eliminate the
          disability claims backlog by 2015
          and ensure no Veteran has to
          wait more than 125 days for a
          high quality decision.
     VA needs to improve timeliness of         VA is automating elements of Post-9/11 GI Bill claims
      Post-9/11 GI Bill claims processing       processing.
      while maintaining the current claims      During FY 2010, VA took the following actions:
      processing timeliness levels for
      existing benefit programs.                   Replaced the Interim Solution –(a manual process
                                                    using a Front End Tool and Job Aids) and
                                                    -   Completed the interface with the VA/Department
                                                        of Defense Identity Repository (VADIR) to extract,
                                                        validate, and populate military service
                                                    -   Converted more than 540,000 records previously
                                                        created in the Front-End Tool.
                                                    -   Provided the functionality to process and pay
                                                        scholarship claims.

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                                                                          Part I – Major Initiatives

                      (PRIORITY GOAL)
     Problem Being Addressed                            FY 2010 Actions and Progress
   Incompatibility between DoD and          VLER is a federal, inter-agency initiative designed to
    VA electronic health records              provide portability, accessibility and complete health,
    systems for Veterans and military         benefits, and administrative data for every
                                              Servicemember, Veteran, and their beneficiaries.
   Inability to interface with third        Progress made in FY 2010 is as follows:
    party health care providers to form       -   VA and DoD improved the exchange of health data
    a complete electronic health care             for wounded Servicemembers by scanning records
                                                  and converting them into portable document format
    record for Veterans and military
                                                  (PDF) then transferring them from DoD military
    Servicemembers.                               treatment facilities to VA polytrauma centers.
   Safeguarding of Veterans and
                                              -   The initial VLER Health pilot in January 2010
    military Servicemembers’                      successfully demonstrated health data exchange at
    Personally Identifiable Information           the first point of care site between VA and one
    (PII) woefully inadequate for                 private partner utilizing the Nationwide Health
    secure exchange of health-care                Information Network.
    information over wide Web                 -   The next pilot phase for exchange of additional
    Networks.                                     health information between VA, DoD, and private
                                                  partner successfully went live in September 2010.
                                                  This pilot increased both the number of points of
                                                  care for health information exchange and the health
                                                  data that are exchanged.

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      Problem Being Addressed                             FY 2010 Actions and Progress
     Nearly 30 percent of the               The Uniform Mental Health Services Handbook provides a
      patients VA sees during a given         comprehensive, forward-looking overview of the full range
      year have a mental health               of mental health services that VA Medical Facilities and
      diagnosis. As a result, VA has          Community Based Outpatient Clinics must provide. Most
      designed its health system on           VISNs have implemented about 90 percent of the handbook
      the basis that mental health is a       requirements. As a result, VA provides a high level, by any
      critical part of overall health         standard, of comprehensive care for mental health
      care. PTSD, depression, and             problems.
      problem drinking are the three         Mental health staff are integrated into primary care clinics
      most common mental health               throughout the VA system; they assist with education of
      conditions afflicting Veterans.         patients and families; follow up on positive mental health
     The goal of Improving Veteran           screens to conduct full evaluations; delivery of co-located,
      Mental Health (IVMH) is to              collaborative psychosocial mental health care; delivery of
      continue the transformation of          Behavioral Medicine interventions for physical health
      Mental Health that began with           problems; medication management; and consultation for
      the publication of the                  other primary care team staff.
      Handbook on Uniform Mental             August 6, 2010 will mark two years since the establishment
      Health Services in VA Medical           of VA’s Suicide Prevention Hotline (1-800-273-TALK (8255)
      Centers and Clinics and                 and Chat Service. Details as of July 8, 2010 include the
      continue to evolve.                     following:
     Ensure clinical services in             -   293,000 calls and 6,300 “chat” connections.
      medical centers and clinics are         -   9,700 rescues of those in immediate suicidal crisis.
      patient-centered and recovery           -   8,600 callers directly linked to immediate care.
      oriented, and address mental            -   35,000 callers provided referral to a VA Suicide
      health needs that emerge in all             Prevention Coordinator; VA continues to work with its
      medical care settings.                      Substance Abuse and Mental Health Services
                                                  Administration (SAMHSA) and Lifeline Partners to
                                                  market the service and increase usage of the Hotline.

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                                                                               Part I – Major Initiatives

      Problem Being Addressed                                FY 2010 Actions and Progress
   The types of client service                    The following actions were completed and/or begun:
    interactions that are common to
                                                    -   Aligned VA organizations and partners to
    Veterans and their families in society
                                                        support the Virtual Relationship Management
    are changing rapidly, along with their
                                                        (VRM) Program (e.g. VBA, VHA, NCA, BVA, DoD).
    expectations for service levels.
   VA has an obligation to change as               -   Transitioned National Automated Response
    well. VA must offer Veterans and                    System (NARS) and Health Resource Center
    their families a higher level of service            (HRC) from Sprint to Verizon.
    by leveraging technological advances            -   Released VA Identity Management Policy to
    to learn more about the needs and                   establish a Master Veteran Index (MVI).
    preferences of our clients and                  -   eBenefits releases 2.4 and 2.5 enhanced
    becoming more proactive in serving                  personalized access to benefit information and
    them in an integrated fashion.                      services delivered through the VA-DOD
    Technology is quickly developing to                 collaborative portal. Release version 2.4 included:
    support extensive self-service, and                 a messaging center, Specially Adapted Housing,
    many clients’ preferences are                       Additional check status of claim for Board of
    evolving toward these interfaces.                   Veteran Appeals, and Opt-in to notify State
   It is crucial that VA provide                       Directors of transitions and interest in state
    consistent information, access, and                 specific benefits. Release version 2.5 included:
    service levels across all interfaces                Insurance SSO integration.
    that are aligned with our clients’              -   MyHealtheVet Single Sign-on (SSO) integration,
    preferences.                                        and accessibility for mobile devices. eBenefits
                                                        exceeded the quarterly target of a 10% increase in
                                                        number of unique Veterans served by the portal
                                                        from 95,000 users in FY10 Q1, to 112,496 users
                                                        FY10 Q2 (18% increase), to 126,650 users FY10, Q3
                                                        (12.58% increase). For more information on
                                                        MyHealtheVet, see Web site at
                                                    -   The following three capabilities will be
                                                        implemented by December 2010:
                                                        -    Call recording capability.
                                                        -    National queue capability.
                                                        -    Health Resource Center Phase 1.

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        Problem Being Addressed                            FY 2010 Actions and Progress
  Patient Aligned Care Team Model                VA launched efforts to add and train staff to ensure
     Veterans and their families are faced       that every Veteran is offered and provided with a
      with the complexities of modern             Patient Aligned Care team to coordinate care, identify,
      health care, which can often seem           evaluate and when appropriate, initiate treatment for
      daunting and confusing.                     medical, psychosocial, and mental health problems.

     There is a need for both health care       VA focused activities on orchestrating and integrating
      systems and health care providers to        health care between primary care and non-primary
      function as a team, led by the              care services and specialists; offering longitudinal care
      Veteran’s personal provider that            for most chronic stable diseases; providing
      works collaboratively with Veterans         comprehensive post-deployment care for the returning
      and their families to improve access,       combat Veteran; and educating, advising, and
      communication, coordination,                counseling Veterans to promote shared
      quality, and safety of health care          decisionmaking.
      delivery.                                  VA providers now administers prevention services
                                                  including health education, immunization, and cancer
                                                  screening, as well as offering diagnostic and evaluation
                                                  capabilities for urgent illnesses.
                                                 VA began implementing multiple initiatives to improve
                                                  access to health care and services. These initiatives
                                                  include the piloting of 59 projects focused on
                                                  improving access to non-institutional long term
                                                  care. Technology is being leveraged to implement
                                                  Secured Messaging and efforts are under way to
                                                  improve access to Women's Health and Specialty Care
  Telehealth: Addressing Access                  Expanded its use of home telehealth-based services to
                                                  support Veteran patients with chronic diseases to
     VA’s expansion of telehealth is             enable them to live independently in their own homes.
      addressing the needs of special            Telehealth-based services now serve an additional
      populations with active programs in         30,000 Veteran patients bringing the VA total to
      the areas of telemental health, post-       280,000.
      amputation care, support of OEF/OIF
      returnees, spinal cord injury and          Piloted the integration of telehealth into its Patient
      other Veterans with other                   Aligned Care Teams model of care.
      catastrophic injuries and illnesses.

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      Problem Being Addressed                              FY 2010 Actions and Progress
   Veterans in rural areas face barriers        VA established four pilot sites to implement enhanced
    to accessing health care or other VA          transportation services. Lessons learned from the
    services. Transportation resources            pilots, as well as best practices will be the foundation
    are not always available.                     for ongoing improvement efforts.
   Scarcity of health care resources in         VA will continue its efforts to address the shortage of
    rural areas requires VA to develop            qualified medical professionals in rural and highly rural
    and implement innovative delivery             communities by identifying strategies and programs
    systems.                                      designed to attract and retain these professionals in
                                                  order to meet current and emerging service needs of
                                                  the rural and highly rural Veteran community.
   There is shortage of readjustment            Through August 2010, VA has placed 176 readjustment
    counseling services for women                 counselors across the Nation.
    Veterans and family members.

   VA needs to improve Veteran access           99 percent of patients have access to care within 30
    to outpatient/ inpatient care, VA will        days of their desired appointment date.
    need to build a culture of continuous        VA employee teams made improvements to inpatient
    improvement within the VA health              care flow and invested in employee training to provide
    care system.                                  staff with continuous quality improvement skills and
   VA is establishing Veteran service           Baselined requirements and awarded contract for
    through interactive point of service          hardware, software and implementation support for
    kiosks at VA health care facilities.          the Veterans Point of Service solution.

    Kiosks will improve VA’s information
    collection without requiring
    significant expenditures in staff
    costs. Kiosks will help improve VA’s
    interactions with patients –
    providing Veterans convenient
    control of their own information.
   Veterans’ understanding of their             Content and rules for the “tailored” health benefits
    health benefits and responsibilities          handbook were finalized and, approved; handbook was
    needs to be improved.                         and tested with 200 Veterans in a “proof of concept”

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                     NEEDS (PREPAREDNESS)
       Problem Being Addressed                           FY 2010 Actions and Progress
     VA needs to build and maintain         VA completed the planning and initial acquisitions to
      capabilities required to serve          establish Integrated Operations Centers (IOC) to be used
      Veterans and their families in          during war, national emergencies, or terrorist attack
      times of crisis.                        situations. IOCs will be the nucleus of information
     VA must be able to serve as             gathering for VA, enabling the development and sharing of
      primary backup to the                   information through state-of-the-art intelligence
      Department of Defense Military          management and fusion processes through which
      Health care System during war or        information is collected, integrated, evaluated, and
      national emergency, and assist          disseminated.
      other Federal agencies with
                                             The IOC at VA Central Office (VACO) in Washington, DC, is
      medical and other services
      during natural disasters or             staffed 24/7 to provide the Secretary and other VA
      terrorist attacks.                      decision makers situational awareness and access to real-
                                              time operational status across the Department.
     Due to VA’s location across time
                                             A Capital Region Readiness Center has been constructed to
      zones, timely communication is
      essential to ensure leadership          serve as a Continuity of Operations site for VACO and as
      maintains situational awareness.        the alternate IOC location should VACO be uninhabitable.
                                             VA established 204 Personal Identification Verification
     No matter what the emergency,
      VA needs to be able to continue         (PIV) badge issuance offices throughout the Nation to
      to provide essential services.          ensure HSPD-12-compliant identification of employees,
                                              contractors, and affiliates. Each office has been outfitted
     With access to timely                   with state-of-the-art information technology equipment,
      information, VA decision-makers         including workstations, fingerprint capture devices,
      will be able to more quickly            cameras, and printers. By the end of 2010, more than
      address emergent operational            103,000 PIV badges were issued to employees, contractors,
      challenges.                             and affiliates.

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        Problem Being Addressed                                 FY 2010 Actions and Progress
    VA has a funding backlog of $24.3               VA developed SCIP, a data-driven long-term strategic
     billion in construction projects and             capital plan to close the identified gaps between
     Facility Condition Assessments (FCS)             facilities’ current conditions and certain
     deficiencies.                                    Departmentwide standards (access, utilization, space,
    Current average utilization of VA                facility condition, energy, safety, parking, and
     facilities is at more than 114% of               information technology).
     capacity, resulting in an inefficient           SCIP integrates VA’s various capital investment
     use of resources and higher                      planning efforts into a single process.
     maintenance costs.                               - This process will result in the creation of a
                                                          Departmentwide 10-year Strategic Capital Plan that
                                                          provides the solutions to addressing identified
                                                      - Projects will be prioritized based on VA approved
                                                          SCIP decision criteria and include addressing the
                                                          most critical gaps first and emphasizing Secretarial

        Problem Being Addressed                                    FY 2011 Planned Actions
    Preparatory work on this initiative began in FY 2010. Described below is the problem being
                      addressed and descriptions of planned 2011 actions.
    Nationally, health care costs are               VA will reduce operational costs and create streamlined
     accelerating without significant evidence        deployment of targeted programs to enhance program
     of a corresponding improvement in                efficiency. This effort will involve a series of strategies:
     health care delivery value or quality.           - Standardizing clinical and business practices related to
                                                           non-VA care.
    VA is experiencing similar phenomena             - Reviewing the process by which specially funded
     VA has the opportunity to optimize cost               programs are evaluated and “sunset.”
     effectiveness by minimizing the local            - Standardizing and automating the business practices
     variations in how programs are                        associated with the Beneficiary Travel Program.
     implemented and managed. These                   - Analyzing the expenses related to various accreditation
     variations in both clinical and business              programs.
     practices are often associated with              - Leveraging existing cost-savings opportunities in the
     organizational inefficiency and increased             area of procurement.
     costs.                                           - Reducing manual processing through the
                                                           implementation of Real Time Locator Systems.

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          Problem Being Addressed                              FY 2010 Actions and Progress
     The purpose of the EWCA initiative is to         In FY 2010, the Cost Leadership Team
      develop a process that identifies,                -   Identified and defined the most relevant cost
      presents, and analyzes the most relevant              information and measurements with management
      cost information and measurements                     implications.
      with management implications. A Cost              -   Acquired contractor support.
      Leadership Team was formed to develop             -   Identified and determined the technical expertise
      a process that identifies, retrieves,                 necessary to develop the software/hardware
      presents, and analyzes cost data via a                foundation necessary to provide a prototype
      prototype dashboard mechanism that                    dashboard.
      provides the most relevant cost                   -   Developed an analysis function.
                                                        -   Developed and presented a prototype dashboard to
      information and measurements with
                                                            senior leadership.
      management implications.
     Monthly Performance Reviews (MPRs)               In FY 2010, the MPR team
      are designed to help the Department’s             -   Aligned MPR reporting elements to VA’s new
      senior leadership focus on top                        strategic planning framework and to four balanced
      congressional, presidential and                       scorecard quadrants: Operations, Financials,
      secretarial priorities, and discuss                   Learning/Growth, and Client Satisfaction.
      mission-critical issues and program
      performance.                                      -   Redesigned presentation of data to more clearly
                                                            show and analyze performance trends.
      -   On a monthly basis, VA Administrations
          and Staff Offices report to the Deputy
          Secretary on progress made in meeting
          established monthly and/or fiscal year-
          to-date financial and program
          performance targets.
     MPRs needed to be aligned with the
      Department's new strategic planning
      framework and structured around a
      balanced scorecard performance
      reporting model to better meet
      leadership information needs.

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    Problem Being Addressed                           FY 2010 Actions and Progress
    This initiative seeks to        Chartered the Integrated Operating Model Board, which is responsible
     increase integration and         for ensuring that the IOM initiative is effectively planned and executed
     improve management               across the Department.
     within and across VA’s          Implemented an IOM Program Management framework and the
     corporate management             necessary policies and procedures to help oversee and monitor the
     functions and provide            planning and actions of the corporate management functions.
     better customer service to   Facilities Management
     internal customers.
                                     Department has begun implementing an enterprise structure that will
                                      integrate facilities management functions and maximize life-cycle
                                      performance while reducing cost. In this context, VA completed the
                                      -   Developed an implementation strategy and plan for
                                          transformation of VA facilities management to an enterprise
                                          system of facility management.
                                      -   Completed process mapping for four focus groups (Planning,
                                          Project Delivery Facility Engineering, and Resource Management)
                                          to develop a system of policies and processes to support project
                                  Acquisition and Logistics
                                     VA will establish a more effective relationship with suppliers for
                                      Perfect Order Fulfillment (POF). POF is defined as the ability to deliver
                                      the right service or product, at the right place, at the right time, with
                                      the right quality and with proper documentation. In FY 2010, VA
                                      -   Developed two-way dialogue with suppliers through additional
                                          periodic Supplier Relationship Transformation (SRT) forums, SRT
                                          focus group, and the SRT Web site.
                                      -   Developed tools to support relationships with suppliers and
                                          improve VA requirements development by leveraging and
                                          implementing industry ideas, SRT Web site, and partnership with
                                          DoD to use their interactive customer evaluation program.
                                      -   Monitored supplier satisfaction by developing and implementing
                                          Key Performance Indicators on customer (internal and external)
                                          satisfaction process.

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    Problem Being Addressed                                FY 2010 Actions and Progress
                                         The Office of Finance (OF) successfully implemented myPay for VA
                                          employees in June 2010. myPay is an innovative, automated system
                                          that electronically manages certain discretionary pay data items, and
                                          allows employees to view, print, and save LES and W-2s.
                                         VA SES/Managers/Supervisors/non-bargaining unit employees no
                                          longer receive a hard copy LES. W-2s will be electronic as well.

                                   Recruitment, Hiring, and Training
                                         In response to President Obama’s mandate to improve the Federal
                                          recruitment and hiring process, VA
                                       -      Completed and submitted VA’s Hiring Reform Action Plan to Office
                                              of Personnel Management and Office of Management and Budget.
                                       -      Trained 2,375 employees through various Financial Management
                                              training conferences.
                                       -      Developed and delivered Project Management “boot camp”
                                              training to 1,500 employees.
                                   IT Project Management
                                         In June 2009, VA began implementing the Program Management
                                          Accountability System (PMAS) to manage all IT development,
                                          modernization, and enhancement programs and projects.
                                         In FY 2010, VA
                                       -      Implemented a PMAS Prototype.
                                       -      Implemented PMAS training.
                                       -      Developed and published revised PMAS Guide.
                                       -      Finalized draft requirements for PMAS dashboard.

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    Problem Being Addressed                          FY 2010 Actions and Progress
    This initiative will help        A key element of this initiative is ADVANCE which represents an
     deliver the highest quality       investment in people development, workforce engagement and
     in medical care, benefits,        talent management for the delivery of health care, benefits, and
     and memorial services by          other services to Veterans and their families.
     creating the conditions for       - ADVANCE will provide employees the opportunity to access
     attracting and retaining a            the VA Learning University’s extensive curriculum of courses
     talent pool of trained,               to build new skills to further their career at VA.
     certified, and inspired          In October 2009 the Secretary established the Corporate Senior
     employees execute VA’s            Executive Management Office (CSEMO) that applies an
     mission.                          enterprise-wide approach to SES management, including
                                       recruiting, retaining, developing, training, and rewarding our
                                       senior executives.
                                      CSEMO initiatives are underway to
                                       - Streamline and standardize the hiring process.
                                       - Ensuring consistency in processes and procedures.
                                       - Partner with OPM to address executive/leader assessments.
                                       - Use executive search firms to attract outside talent.
                                       - Drive a culture of continuous learning for executives.
                                       - Overhauling the SES leader development program.
                                       - Providing executive coaches.
                                       - Develop a robust on-boarding process.
                                       - Deliver performance management training and a
                                           performance management system that focuses on the
                                           Secretary’s priorities and encourages and rewards creativity,
                                           innovation, intelligent risk-taking, critical thinking, and
                                       - Provide succession management and workforce planning.

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     Genomic Medicine: Improved                   VA initiated a study on the use of genomic medicine to
      information on prevention,                    inform the course of care (prevention, diagnosis,
      diagnosis, and treatment options for          and/or treatment) of patients with serious mental
      Veterans with serious mental illness          illness.
      (bipolar disorder and schizophrenia)          -   The study aims to identify the genetic basis of
      is needed.                                        Veterans developing either of the two diseases and
                                                        the genetic basis of disability in daily function (e.g.
                                                        employment, self care) among the same patients.
     Access to Care: Veterans who (1) are         A conference on Access to Care was held in September
      geographically distant from VA                to identify research priorities.
      medical facilities, (2) lack capability      VA began three research projects aimed at improving
      of transport to nearby facilities,            VHA health care access for Veterans:
      and/or (3) receive, or appear to
                                                    -   Prolonged Exposure for PTSD: Telemedicine vs. In
      receive, unequal treatment due to
      factors such as race, ethnicity,                  Person.
                                                    -   Telemedicine Outreach for Post-Traumatic Stress in
      gender, addiction, or mental health
      status, often lack access to adequate             Community Based Outpatient Clinics.
                                                    -   The Impact of Remote ICU Monitoring on Patient
      health care.
                                                        Outcomes and Processes of Care.

     Deployment Health: Mild traumatic            VA began three research projects aimed at developing
      brain injury (TBI) remains a concern          new objective methods for diagnosing mild TBI. These
      for Veterans returning from military          studies are examining various methods of diagnosis,
      service but its long term                     including portable eye movement tests and Magnetic
      consequences and effective methods            Resonance Imaging (MRI) and functional MRI imaging.
      of diagnosis are unclear.

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      Problem Being Addressed                               FY 2011 Planned Actions
    Preparatory work on this initiative began in FY 2010; described below is the problem being
                      addressed and descriptions of planned 2011 actions.

VHA has long been considered the world          VA will launch an innovative and agile approach to
leader in developing and utilizing               software development that is designed to explore,
information technology (IT) to improve           discover and implement best practices.
delivery of high quality, cost effective
                                                A prototype model and foundation for future
health care.
                                                 development of clinical software solutions will be
VA’s leadership position is being                established to positively transform the health
challenged in today’s rapidly evolving           professional experience, increase patient
environment creating a sense of urgency          engagement, and address population-based aspects of
to maintain our position as a pacesetter         health care delivery through implementation of an
in health IT advances and remain on the          open, extensible architecture and modern
leading edge. These challenges include:          technologies to accelerate innovation in co-existence
-   Making a major shift in the health           with legacy VistA.
    care delivery model to a team-based         Two prototypes will be based on the A Virtual
    patient-centered model of care.             Implementation of VistA (AViVA) environment; a
-   Moving away from a process-                 browser-based user interface and a multi-tiered
    oriented VA software development            architecture will serve as the foundation for VA’s
    model, which fails to maximize on           Electronic Health Record modernization.
    meaningful clinical input and falls
    short on delivering timely software         VA will establish a framework to strengthen the
    solutions.                                   informatics and analytics capacities of the VA
                                                 workforce and thereby create sustainable capacity to
                                                 continue health care modernization in the future and
                                                 support improved care delivery, and ensure strong
                                                 partnership between health IT and clinical initiatives.

                                               FY 2010 Performance and Accountability Report / I - 79

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