While the attention to the Department of Veterans Affairs’ electronic health record modernization initiative seems to never end, another major IT initiative is struggling and starting to grab the interest of Congress — and not in a good way.
VA is two years into a supply chain modernization effort and it is teetering on the abyss for a variety of reasons, including a court ruling that has shut down part of the initiative, and a lack of overall strategy to address standards and typical technology and culture complexities.
“For me as chairman, modernizing VA’s supply chain systems is a high priority, and it does not appear that things are going well with the supply chain system even with the extra CARES Act money that we provided,” said Rep. Mark Takano (D-Calif.), chairman of the Veterans Affairs Committee, during a Sept. 30 hearing on VA IT modernization efforts. “I’ve got to tell you that failure to modernize the system is not an option. I know Dr. Evans you are new to your position as acting CIO, but this is a priority and I hope that you all will focus in on it. I know this is a long-standing problem, but we have to get our arms around it.”
What some estimate to be a $2 billion project, VA has been working on this effort since 2019 when it agreed to move to a 20-year-old system from the Defense Logistics Agency called the Defense Medical Logistics Standard Support (DMLSS), and off of their own 30-year-old supply chain logistics management system.
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VA’s goals for this initiative is two-fold: One part is to modernize its inventory management system, and the other is to move to DLA’s existing contract vehicle and away from its current set of vendors.
While a Court of Federal Claims decision in July all but stopped the move to the DLA’s medical and surgical contracts for the near future, it’s the other piece of the initiative that is causing deep concern among lawmakers and industry.
In more than a year, VA only has implemented the DLA inventory management system at the Captain James A. Lovell Federal Health Care Center in Chicago.
Takano and ranking member Mike Bost (R-Ill.) and Sens. Jon Tester (D-Mont.) and Jerry Moran (R-Kan.), chairman and ranking member of the upper chamber’s Veterans Affairs Committee, respectively, wrote to the VA in July, after the court’s ruling, asking for more details about the supply chain modernization plan.
“VA must explain how it plans to adapt to this new reality. Bifurcating the VA medical surgical supply chain between VISNs 20 and 6 and the rest of the United States is not a viable long-term strategy,” the lawmakers wrote. “A patchwork of supply chains would undermine standardization, present management challenges, increase waste and create unnecessary complexity. There is not a clear path forward to widespread adoption of the DLA medical surgical prime vendor contracts, and substantial changes must be made to the MSPV 2.0 solicitation.”
Roger Waldron, the president of the Coalition for Government Procurement, an industry association whose members are part of VA’s medical supply chain, said this modernization effort has been challenging for many years.
“The VA’s industry partners look forward to engaging with VA leadership on the MSPV program and the IT logistics systems that support it,” Waldron said in an email to Federal News Network. “Stakeholder engagement will ensure the broad input necessary to fully understand and address the technical, management, logistical, and procurement considerations facing the program.”
Since that letter, a committee aide for the majority said they have not heard much from VA about their plans.
The aide said while VA responded to the letter, Takano remains concerned.
“We are getting into the phase of getting deeper into it, and it feels like they are having to do a restart,” the aide said. “The committee plans to have hearing in November on this program.”
During the hearing, Todd Simpson, the deputy assistant secretary of DevSecOps, said VA is planning to further deploy the inventory management system at the medical health centers in the Pacific Northwest, known as VISN 20, during mid-fiscal 2022.
“Our main focus with DMLSS is obviously to support the common core technologies to enable a successful DMLSS implementation. We are focusing on a DMLSS cloud enclave that is going to provide testing and training capabilities to practioners and users, and that is really where most of our emphasis is right now in our DMLSS journey,” Simpson said.
A committee aide for the minority added VA’s decision to continue to implement DLA’s inventory management system DMLSS remains disconcerting.
The committee aide for the minority said VA’s current plan is to move fully to DMLSS by 2027, three years longer than initially planned. There are some discussions about accelerating the timeline to be completed by 2025.
Part of the reason why DMLSS implementation will take so long, the committee aide said, is first VA will implement it in on-premise data centers, and then move to the cloud.
The aide said instead VA could skip that initial on-premise implementation and move directly to the cloud through the Defense Health Agency’s system called LogiCole when it’s available in 2025.
“If an inventory management system is the most important thing, which we agree with, let’s go out and identify the best one and buy it,” the aide said. “We know VA struggles with multi-year, multi-billion dollar big bang IT programs. We believe we can avoid doing another one of those and meet the requirements for a modern system in a better faster, more agile way.”
In many ways DMLSS seems to be stuck in VA’s old way of thinking about IT modernization through a waterfall or more stringent approach. Given the challenges during the pandemic, it seems to make sense for VA to change gears and look for a more modern, agile, cloud system as medical supply chain management doesn’t seem like a unique challenge for VA.