Nearly 20 years after the Department of Veterans Affairs (VA) first identified the need to modernize its scheduling system, VA is on track to adopt a permanent scheduling solution as part of its electronic health record (EHR) modernization effort, according to a report from VA’s Office of the Inspector General (OIG) today.
VA’s long journey to replace its scheduling solution stems from the usage of the VistA EHR system, which was developed by VA in the 1980s. By the 2000s, when VA sought a replacement for scheduling, the department found “no COTS [commercial off-the-shelf] software developers appeared willing to make their scheduling application compatible with VA’s systems,” the report notes. VA undertook its own Replacement Scheduling Application (RSA) development project, but after seven years of in-house development and $127 million in funding for the total effort, the department acknowledged that it had not developed or acquired any new scheduling capabilities.
Since the failed effort to develop a scheduling solution in-house, VA has piloted COTS solutions and improved its existing scheduling system under the VistA Evolution effort, but did not land on a long-term replacement for the scheduling system. In addition, OIG found that the VistA Evolution effort was not effectively managed, with delays in deployment and incomplete requirements for contractors. OIG found that turnover, unresolved issues, and inadequate requirements delayed implementation, which remains incomplete today.
In December 2018, VA announced its intention to use Cerner’s solution for scheduling on an accelerated timeline, due to the “return on investment in productivity and efficiency.” While the scheduling solution will not start implementation until the EHR initial implementations begin, the scheduling solution will be deployed at most sites before EHR.
Taking the context into account, OIG recommended that VA improve oversight for implementing a new scheduling solution, which VA concurred with.