The U.S. Veterans Affairs Secretary David Shulkin, MD, candidly opened up to reporters about the ‘chronic issues’ plaguing the agency -- and what he intends to do about it -- during a rare appearance at a White House press briefing Wednesday.

In what he called a “top-to-bottom review” of the agency’s challenges, Shulkin named the VA’s biggest flaws: care access, healthcare quality, reimbursement to providers who care for veterans outside of the VA, extending the choice program and the VA’s severely outdated IT system.

“The only way to fix the issues is to come out and talk about what those problems are. And there is still a lot of work to do,” said Shulkin.

[Also: OIG blasts VA over IT security controls, calls standards weak, unsafe]

“Twenty percent of our system is running on out of date IT,” he said. “And 75 percent of the IT budget is spent on just maintenance. Our legacy systems are old and crippling, while our schedule and maintenance systems are outdated.”

Shulkin said that the scheduling and maintenance systems are in the process of being replaced, but it will take years to complete. Further, the system the VA uses for loans is in crisis, and without funding, the agency will need to revert back to a paper system.

VA is looking to either outsource its current IT system to a commercial vendor or replace the outdated VistA with a commercial off-the-shelf system, said Shulkin. And the IT issue is the most cost-intensive issue on his to-do list. He plans to return to Congress for more funding once he’s made his decision on the IT system’s fate by July.

[Also: VA to Congress: Trump's budget will modernize veterans care]

But he stressed that outside of IT issues, the president’s proposed budget will help to remedy the VA’s issues.

“The problems in VA won’t be solved through more money, but through management focus and legislative backing,” said Shulkin. “VA’s issues aren’t due to money.”

At the moment, veterans are able to get same-day care at medical centers, but new appointments are still plagued with extraordinarily long wait times. The average wait-time hovering around 60 days at 30 locations, many primary care sites are understaffed and disability claims appeals can take three years to process.

“Sixteen percent of primary care clinics are over 100 percent capacity, and when that happens, we can’t provide access to care,” said Shulkin.

And when veterans go out into the community to one of the 500,000 participating community care providers, it takes more than 30 days to process 20 percent of claims. And, as of April, only 65 percent of claims are handled electronically.

Shulkin urged Congress to help combat these issues with legislation to ease some of the burden -- which includes extending the choice program to ensure veterans won’t need to wait for care. He’s also hoping to forge private sector relationships to determine the best path forward.

“The president has a strong commitment to improving VA and is committed to improving VA’s healthcare,” Shulkin said. “I want to be held accountable to fix this, but we need help from Congress. This is our commitment to fix these problems that have plagued the VA -- at times for decades.”

“I’m confident we can turn the VA into an organization that VA families and veterans deserve,” he continued.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com

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