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GOVERNMENT INSIGHT

How digital transformation supports the VA during the pandemic

On the frontlines of innovation, the Department of Veteran Affairs’ Office of Information and Technology (OIT) is battling the COVID-19 pandemic shoulder to shoulder with our VA partners while maintaining the department’s mission: to care for America’s 20 million veterans.

OIT’s digital transformation strategy prepared VA to more than double its hardware and IT infrastructure capacity, transition to a remote workforce and deliver critical services to veterans and VA medical facilities across the nation at the onset of COVID-19.

Enabling a remote workforce to deliver on mission objectives

As the number of COVID-19 cases rose, OIT enabled a nearly three-fold increase in VA’s remote workforce that could continue to serve America’s veterans while helping their communities flatten the curve. OIT promptly expanded network access via the Department’s RESCUE virtual private network and Citrix Access Gateway to provision an ultimate capacity of 500,000 users with RESCUE and more than 130,000 users with CAG.

Conference tools, such as VA Video Connect, are keeping staff connected to veteran patients, and other video conferencing tools like Webex and Microsoft Teams connect internal teams. Additionally, more than 225,000 laptops and 100,000 mobile devices are being purchased and deployed for staff members at Veterans Health Administration (VHA) sites.

Meeting veterans’ needs with telehealth

VA’s investment in telehealth over the past decade and dedication to serving nearly 5.2 million veterans living in rural communities positioned the department to rapidly expand delivery of care. Today, telehealth platforms enable non-COVID-19 patients (and those experiencing mild symptoms) to be treated from home, limiting unnecessary exposure.

OIT expanded capabilities of VA’s primary telehealth service, VA Video Connect, quintupling visit capacity to handle more than 35,000 daily telehealth visits versus 3,000 prior to the pandemic.

Two other VA telehealth services, the My HealtheVet patient portal and Rx Refill, are experiencing sharp increases in user engagement. My HealtheVet has seen a 30% increase in appointments -- reaching more than 470,000 total -- and Rx Refill filled over 461,000 prescriptions in the first two weeks of April alone.

VA and OIT also expanded use of Tele-ICU, which allows all intensive care units in a network to have 24/7 access to an intensivist-led care team and specialists. Team members can remotely monitor and assess patients and are alerted if a situation requires intervention.

Meeting veteran’s mental health needs is critical during a time when symptoms are exacerbated by isolation. Since February, OIT has enabled providers to complete more than 30,000 appointments using VA Video Connect (a 70% increase), 2,700 group therapy sessions (a 200% increase) and more than 154,000 care and consultation appointments (a 280% increase).

Tackling the pandemic with innovation

VA contact centers have experienced a surge in call volume as a result of social distancing measures, resulting in extended hold times, staffing challenges and delayed access to clinical advice. In response, OIT launched an interactive chatbot to help answer routine and non-critical COVID-19 questions.

But innovation didn’t end there. When VA began treating COVID-19 patients, VHA needed ground-level situational awareness of cases in the VA system. OIT built the National Surveillance Tool to help make timely and informed decisions, such as when and where to cross-level supplies or personnel.

As patients and staff return to a new normal, OIT developed and launched “I am Here,” a virtual tool that allows patients to check-in remotely at VA medical facilities and a digital pre-entry screener app that allows individuals to answer pre-screening questions, expediting entry at VA medical centers. We are also deploying tools to help veterans determine when they should go to a facility versus stay at home, and a facility locator that displays facility-specific status related to COVID-19 (this feature will also be used for local emergency operating status updates).

A path toward victory

OIT’s ability to rapidly respond to the pandemic is a strong testament to VA’s early undertaking of digital transformation initiatives and robust partnerships with VHA, Veterans Benefits Administration and the National Cemetery Administration as well as the technology industry at large.

The department’s agility also points to its commitment to engaging the next generation of the federal workforce. As COVID-19 response efforts continue, OIT is dedicated to developing top talent to advance ground-breaking innovation to battle this black swan event while ushering in a digital future for our nation’s veterans.

OIT continues to share findings with other government agencies and private health care systems to tackle this pandemic and aid in a successful recovery. As response efforts continue, OIT is building on best practices and lessons learned to agilely pivot based on need. Our business partners -- and the 20 million veterans, caregivers and survivors we are responsible for -- depend on us to be increasingly efficient and effective in the delivery of benefits and services our nation’s heroes have earned.

About the Author

James Gfrerer is the Department of Veterans Affairs' chief information officer.

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