The Veterans Affairs Department is centralizing information technology systems, management and processes with one primary goal in mind, according to VA's top enterprise infrastructure engineering official: to ensure that veterans anywhere in the country get the same level of care.
Charlie De Sanno, executive director of VA's Office of Enterprise Infrastructure Engineering, said that until two years ago, the department's approach to IT was decentralized, in which an individual hospital's level of service depended on how much it invested in information systems.
Some facilities invest more in IT than others in VA's network of 1,400 hospitals, clinics and nursing homes, De Sanno said in McLean, Va., on Wednesday, after speaking at the annual Federal Networks conference, sponsored by Telestrategies and Suss Consulting. Central IT management will ensure that veterans have the same experience whether they go to a VA hospital in Brooklyn or Boston, he said.
A key part of the project is to pull computing operations out of 126 local sites serving the Veterans Health Administration and consolidate them into four regional data processing centers. But that effort hit a hurdle in August 2007, when an outage knocked out vital information systems at VA hospitals and clinics operated in Alaska, northern California, Los Angeles, Hawaii, Guam, Idaho, Nevada, Oregon, west Texas, American Samoa, the Philippines and Washington state.
The outage resulted from a tweak in the systems at the Sacramento data center that mismatched the speed of servers with the speed of a telecommunications switch, De Sanno said, adding that it was human, not technological, error. Dr. Ben Davoren, director of clinical informatics at the San Francisco VA Medical Center, called the outage "the most significant technological threat to patient safety VA has ever had."
The IT staff came away from that outage with a couple of valuable lessons learned, De Sanno said. First, VA needs to tightly control and supervise change and configuration management, he said, as well as diversify computer resources.
The Sacramento data center supported 17 hospitals and their outlying clinics. In the future, fewer hospitals will be supported by beefed-up regional server farms, De Sanno said. The plan includes two- and three-server clusters that will support six hospitals and provide redundancy. Supporting fewer hospitals from a server cluster will make it easier to restart the system in case of a failure, De Sanno said.
VA also is in the process of transforming its award-winning but aging Veterans Health Information Systems Technology and Architecture (VistA) electronic health record system, Robert Howard, VA assistant secretary for information and technology, said at the conference.
He said VistA, which is based on programming language developed in the 1960s, needs to be updated to function in a Web-based world to serve highly mobile clinicians and patients. As VA works to improve VistA, he vowed, "we will not break it." The transition will be a slow process, De Sanno said, with some core databases in use a decade from now.
Another challenge the department faces this year is switching its nationwide networks from the Sprint FTS 20001 contract to the General Services Administration's new Networx contract, held by AT&T Government Solutions, Verizon Business Services and Qwest Government Services, David Cheplicik, executive director of VA's Office of eEnterprise Telecommunications, said at the conference. He expects VA to award its Networx contracts by April.