Department of Veterans Affairs Gets Real Stuff Done

The VA is getting a lot of good work done, using IT to much better serve veterans by helping address the disability claims backlog, maybe their biggest challenge. Sure, the tech is a work in progress, but the greater issue involves skepticism and low expectations.
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In this Nov. 2011 photo provided by Irene Tanabe, Frank Tanabe holds a replica of the Congressional Gold Medal in Washington, D.C., awarded collectively to Japanese-American veterans of World War II, including those who served in his unit, the Military Intelligence Service. A photograph of a 93-year-old World War II veteran casting what will likely be his last ballot has captured the hearts of tens of thousands of Internet users. (AP Photo/Irene Tanabe)
In this Nov. 2011 photo provided by Irene Tanabe, Frank Tanabe holds a replica of the Congressional Gold Medal in Washington, D.C., awarded collectively to Japanese-American veterans of World War II, including those who served in his unit, the Military Intelligence Service. A photograph of a 93-year-old World War II veteran casting what will likely be his last ballot has captured the hearts of tens of thousands of Internet users. (AP Photo/Irene Tanabe)

(From the Department of Giving Credit Where Credit's Due.)

The VA is getting a lot of good work done, using IT to much better serve veterans by helping address the disability claims backlog, maybe their biggest challenge. Sure, the tech is a work in progress, but the greater issue involves skepticism and low expectations.

Toward this end, they had to change the way they built IT systems, getting together a partnership between the IT people and end users and including stakeholders, like employees and veterans service organizations. That's not easy in any organization, and a rarity in government. Could be the way IT should work everywhere in Washington, ending the era of big spending on failed projects.

Please don't underestimate this accomplishment; in my industry, incremental development engaging people who'll use the software, that's the norm. However, it's not business as usual in private industry, and rare in government where cost overruns and late delivery of buggy software is frequent.

A big problem, though, is about outdated expectations and getting the word out to stakeholders. That is, more people outside Washington need to hear about what's going on, and to see that this computer work actually gets the job done. More on this in a moment.

Veterans can receive ongoing financial benefits from VA, but that means getting through the disability claims system. That involves huge amounts of paper forms and documentation, which is often hard to fill out, and suffers from the usual problems. Moving paper around is slow and expensive, and increases the likelihood of getting things lost.

Toward that end, VA has built and is now deploying the Veterans Benefits Management System, all about online workflow management. What's really novel about VBMS is that it was built by IT people working along with the people who'll use it. That's a novelty for government -- it's real cultural change.

Filling out disability claims forms is challenging for anyone who doesn't do a lot of it. So VA is making that easier with VONAPP Direct connect (VDC) on eBenefits. VDC lets a veteran submit a compensation claim online in a turbo tax like, drop down format. VDC isn't a form, it is an electronic interview process that even pre-populates with the information VA has on the Veteran.

Vets frequently get help from Vets Service Organizations, VSOs, either at nonprofits or local government and VA wants to partner with the VSOs to improve service. VA is deploying an electronic interface for VSOs called the Stakeholder Enterprise Portal (SEP). The deal with SEP is that qualified VSOs can use VDC to directly submit the veteran's data into VBMS to build a claim and to track the status as it gets processed. Having this realtime info on the claim makes VSOs even more valuable in the eyes of veterans.

The reality for many VSOs is that they work with existing front end claim builders, like VetPro, to fill in claim forms right, but on paper. The Digits to Digits effort, D2D, defines the means by which existing software can talk right to VBMS.

In addition, VA is doing some real innovative partnership work with employees, hearing from frontline workers about simple changes with large benefits. For example, if a vet condition has been certified by a private doctor, then there's no point in doing that again with a VA doctor. That suggestion has resulted in the Disability Benefits Questionnaire, which helps get vets qualified more quickly and easily, saving time and money.

A related effort to speed processing is called Fully Developed Claims.The deal is that a claim that's submitted with all the supporting medical records can be processed relatively quickly. Otherwise, VA must send multiple requests and gather evidence from multiple sources to substantiate a claim--which is a main cause of the backlog. Fully Developed Claims also free up time for VA people to work on more challenging claims, or to work on old claims.

We're seeing other existing partnership efforts pay off for vets. Google, as part of its VetNet effort, has worked with the Chamber of Commerce, Institute for Veterans and Military Families, Hire Heroes USA, VA and DoD to build the Veterans Job Bank. The deal is that employers mark job postings as suitable for vets, maybe even with a preference. You can find it at www.nrd.gov/jobSearch.

The Blue Button effort is also paying off for veterans, it can be used to download and share both medical and service record info, which is being used by vendors who can read and update Blue Button info for better ongoing treatment.

Finally, VA just announced a contest where private software developers are challenged to write software that talks to the existing VA clinic systems. The clinics systems, Open Source VistA, is a really big deal, an early success story. Newly notable is the "open source" part, enabling new ways for VA to engage in partnership.

Partnership has been critical to each VA success, but that partnership has been limited to parties in Washington or in limited local areas.

However, there's been very little outreach to stakeholders outside that relatively small community. Success is inhibited, it's at risk, unless stakeholders hear about good efforts -- particularly, they need to hear about new, successful efforts. That is, if no one's talking about a successful effort, it hasn't happened.

Those stakeholders include:
  • veterans and their loved ones
  • VA line workers throughout the system
  • nonprofit VSOs, local and national
  • government VSOs, generally local
  • politicians genuinely concerned with vets
  • Americans who support vets
If you don't keep people in the loop, it's a lot harder to get their buy-in and cooperation.
However, inclusion is really difficult to accomplish for a bunch of reasons, cultural and practical.
  1. The deal is that the VA is getting a lot done within the spirit of internal and external partnership. However, a lot of stakeholders are way out of the loop, and are frustrated about that. They don't see much progress, and expect what they observed in the past, lots of money being spent with few effective results.Keeping people in the loop is just not expected in U.S. government or business culture, no one teaches it.
  2. Knowledge is power, and not sharing is normally perceived as a means of retaining power.
  3. Bad actors in the press will seize on released news, and will ignore good news, but will attempt to buy audiences by exaggerating bad news.
  4. In Washington, failure is very damaging and success is rewarded not so much; personal networking dominates. (Contrast that to the Silicon Valley perception, where failure is just perceived as normal on the way to success.)
Well, people of goodwill can maybe help address that, first by writing a post focusing on success and how t got there, with brevity. (Done?)

Next, well, would be finding a way to broadcast VA success, along with some ideas of what made these efforts successful, or potentially successful. In these cases, the critical success factor involves the kind of partnership perspective one doesn't often see in Washington. I guess I've just volunteered to partner up.

I feel that we need to get this stuff to all stakeholders, seriously engaging VSOs and the VA, making sure we listen to line workers. (Seriously, I suspect I've just volunteered.)

Personally, I feel a lot of affinity for efforts like this. I figure that if an American is willing to risk a bullet for me, I should give back.

As a nerd, well, I'm an IT guy. As a customer service rep, I'm emotionally invested in the perspective of line workers and their customers.

A nerd's gotta do what a nerd's gotta do.

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