Inside VA's island of budget stability

Over the last five years, few non-defense agencies have been subjected to as much scrutiny as the Department of Veterans Affairs.

Its problems – from claims backlogs to inadequate health care access for veterans, to high-profile cybersecurity incidents – have been well documented. However, in more recent years, the department has successfully rolled out many changes that have addressed its material weaknesses and challenges. It’s also created plenty of opportunity along the way.

Despite the uncertainty swirling around much of the government, the VA opportunity looks set to continue for the remainder of fiscal 2017 and moving into 2018. As we approach the end of the current continuing resolution and look for another one to replace it, VA is the only non-defense agency with a new appropriation for 2017, which means it has the flexibility to start new programs and implement strategic changes to their workflow, business processes and technology stack.

Moreover, improving the quality of service coming out of the VA was a significant campaign plank for the Trump administration, so it’s a safe bet that its funding will continue to be a priority.

With that background in mind, here are some of the major trends we expect to see driving VA purchasing activity over the next 18 months:

• This is the year of the cloud. The biggest effort is the department’s Enterprise Cloud Services (ECS) project, which resulted in the award of a cloud brokerage contract to CSRA under HHS’s CIO-SP3 vehicle. The company will act as the prime broker to help VA manage its modernization via the cloud. The ECS program will provide an enterprise-wide cloud migration and implementation strategy, building on the success the department has already had migrating the MyHealtheVet program. VA’s cloud implementation will be led by the Enterprise Program Management Office (EPMO) at headquarters, so make sure to stay in front of them to get the latest on the department’s cloud strategy.
• VistA is expanding. The conversation around the fate of VistA, the department’s homegrown electronic health record, has been going on for years. But this year, we’re seeing some real movement in the form of the Digital Health Platform (DHP). VA wants to use the DHP to fundamentally transform the services it delivers to the veteran, as well as the way those services are accessed and managed internally. DHP includes modules supporting supply chain management, financial management, HR management and data interoperability through API integration. So watch this space for future interoperability projects with private medical providers and the Department of Defense. Much of this activity also hinges on the future of the VistA EHR, which VA Secretary David Shulkin recently indicated may finally move to a commercial solution.
• The OI&T leadership structure is future proofed. Over the last few years, the pace of change at the headquarters IT organization has accelerated, and the driver was a recognition that many of the department’s technology challenges came from a poorly optimized leadership structure. New groups like the revamped CISO office, the EPMO and the new IT Operations and Services (ITOPS) office were designed to protect forward momentum on strategic VA technology programs, even during a leadership vacuum or funding uncertainty. This means that even in the absence of a Senate-confirmed CIO, VA should be able to carry out some of the more ambitious projects it’s been discussing.

In many ways, VA is an island in the storm – the rare agency that is the subject of bipartisan focus because both sides agree that it should be expanded and improved, not cut. That means that the broad trends discussed here are by no means exhaustive. The department is at a crossroads, and in many ways, its technology direction will be indicative of the Trump administration’s technology preferences more generally.