The U.S. Government Accountability Office issued a report this week making recommendations for the ongoing Department of Veterans Affairs' IT modernization program.  

As noted in the GAO report, the VA has been attempting to replace its aging financial and acquisitions systems with an integrated system for years.

The latest deployment, in November 2020, followed some IT best practices, but the cost and schedule estimates "only minimally or partially met" many others, said the report.  

"Following information technology management best practices on major transformation efforts … can help build a foundation for ensuring responsibility, accountability, and transparency," wrote report authors.  

WHY IT MATTERS  

The VA's core financial system is three decades old. It is also not integrated with other relevant IT systems, meaning users have to implement complex work-arounds to effectively use it.  

"Weak financial management makes it more difficult for VA to achieve its mission of serving our nation’s veterans, as well as meeting requirements for transparent and accurate public reporting of financial information," wrote the report authors.

The Financial Management Business Transformation program, established in 2016, represents the agency's third attempt to overhaul the acquisition and financial systems into one integrated setup.   

"Specifically, this program is intended to increase operational efficiency, flexibility and scalability using a modern enterprise resource planning solution to provide real-time integration between financial and acquisition information across VA in a single, consolidated system," wrote report authors.  

After the first deployment of some FMBT capabilities this past November, officials flagged challenges including funding shortfalls and coordination with other major initiatives – including the electronic health record modernization efforts, which have faced their own pitfalls.  

"To address this challenge, as part of its efforts to plan wave deployments, the FMBT program coordinates with other priority initiatives at VA, such as the Electronic Health Record Modernization program and the supply chain modernization efforts that the VA Logistics Redesign program manages," read the report.

In other words, the new integrated financial system, called iFAMS, will not be implemented at the Veterans Health Administration for at least two years to coordinate with the implementation of the new EHR and logistics systems.

The GAO report found that the FMBT program has generally followed IT management best practices, except those relating to cost and schedule implementation.  

"Without reliable cost and schedule estimates, VA management may not have the information necessary for informed decision-making," read the report.   

"Further, following cost and schedule best practices helps minimize the risk of cost overruns and schedule delays and would better position the FMBT program for effective and successful implementation on future deployments," it continued.  

THE LARGER TREND

The VA's various IT modernization efforts have been the subject of scrutiny, particularly after hundreds of patient safety concerns around the rollout of its new Cerner EHR in Washington state.  

The agency is currently undertaking a strategic review of that program and has pledged to pause a second-site go-live until that review is completed.

Meanwhile, President Joe Biden has requested more funding to go toward such efforts, among his other health IT priorities.  

ON THE RECORD

"Continuing to identify and address new and existing risks and challenges in future deployments of financial and acquisition management capabilities at VA’s remaining administrations and staff offices will be key to successful implementation," read the GAO report.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.