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VA’s Scheduling System Revamp Will Be Big Test of Agency’s Agile Approach

Matt York/AP

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By Jack Moore August 29, 2014

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The last attempt by the Department of Veterans Affairs to update the system used by hundreds of VA facilities nationwide to schedule and manage veterans’ medical appointments was one of those failed IT projects that have come to hog the spotlight in the post-HealthCare.gov age.

In 2009, after eight years of development and costing $167 million, VA canceled that program after it failed to deliver the promised capability.

VA this week announced it would kick off the search for a full replacement system beginning next month.

And even amid the scandal over the agency’s handling of patient times -- stemming in no small part from the archaic system VA had been saddled with -- agency IT officials are bullish failure won’t be an option this time.

That’s because since the failure of that last attempt, VA has been taking a new approach to modernizing its legacy IT systems. Rather than building massive, monolithic systems with development lead times stretching into years, the agency is breaking big projects into smaller pieces and making sure they can deliver functionality in the short term.

It’s called agile, or modular, development. Five years ago, VA began pushing project managers to deliver key parts of projects in six months or less. If a project couldn’t meet those deadlines, it faced the chopping block.

Stephen Warren, VA’s deputy chief information and de facto head of the Office of Information and Technology, says the agency will stick with the agile approach when it goes to link up the new commercial scheduling software it’s seeking to buy with VA’s systems.

"All our policies, all our practices with agile -- this will have to meet,” Warren told Nextgov this week after a speech at a conference on modernizing legacy IT systems hosted by the Institute for Defense and Government Advancement.

VA Goes Agile

More than two years ago, the Office of Management and Budget exhorted agencies to think about agile development as a potential remedy to the propensity of large-scale IT projects to run off the rails.

VA was an early adopter. It ramped up its use of agile in 2009, coinciding with a broader overhaul of the agency’s IT shop in which disparate functions were centralized into a single office and a new management accountability system was rolled out to keep projects on track.

Those efforts appear to have paid off, according to statistics Warren presented at the conference.

In 2008, the year before VA launched the new initiative, only 32 percent of its projects actually met their delivery deadlines. Over the next two years, during which project managers were under the gun to deliver capability in six-month increments, the number of projects successfully delivering capability rose to more than 80 percent.

“We said, ‘If you can’t break it into pieces, you’re dead,’" Warren said.  

No ‘Path to Nowhere,’ Official Says

About a third of the projects were able to be restarted almost immediately under an agile framework, he said. But about a third of the project managers "could not get their heads around it," Warren said -- and the initiatives were ultimately canceled.

Currently, about 80 percent of VA’s IT projects, whether infrastructure or software, "deliver on the date I said I was going to deliver on," Warren said. He’s not shy about shutting a project down if it can’t deliver, he added.

Six-month delivery cycles allow Warren’s office and VA leadership to know if a project will fail to cross the finish line much earlier in the process.

"In less than a year, we can tell if a major project is destined for failure,” he said. “Think about how it is normally: In three to five years, you realize, ‘I'm on the path to nowhere.’"

Agency Shifts to 'Achievable' Goals

Some bumps in the road, however, remain. For 2014, VA’s track record of on-time projects is set to decline to about 70 percent, which Warren blamed on last fall’s government shutdown.

Still, he said VA would likely demur from ever setting the goal at 100 percent.

"We learned that already with the scheduling activity, right?" he said, referring to the ongoing scandal over VA medical center staff manipulating wait-list data to meet steep goals for providing veterans’ care.

"If you establish a measure, if you establish an outcome, that is not achievable, people will lie,” Warren said. “You gave them no choice. You forced the organizational construct for them to do something: Either go or do bad things. And that's what we've been dealing with."

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