VHA Deploys Agentic AI Operating System to Improve Care Delivery

The Veterans Health Administration deployed an agentic AI-based operating system across more than 150 VA medical centers and outpatient facilities this week to streamline operations and improve care delivery for up to 18 million veterans, according to agency officials.

The system connects clinicians, administrators and caregivers through a unified platform designed to simplify incident response, reduce administrative burden and accelerate decision-making across the enterprise.

“It allows humans to focus on the things and the care that matters. That’s where we’re creating efficiencies up an down, vertically and horizontally across the organization with this performance management system,” Josh Geiger, portfolio manager for Access and Operations at VHA, told reporters Thursday at the Salesforce World Tour D.C.

Geiger said the platform addresses a longstanding need for a single operating environment that integrates tools, software and data. By consolidating workflows, the platform enables teams to share best practices, improve efficiency and reduce costs. 

Slack Powered by AI 

Developed by Salesforce, the system integrates service management and patient care coordination into a single AI-powered platform built on Slack. The effort is part of VHA’s broader shift from static reporting to automated, data-driven problem-solving, eliminating administrative silos and enhancing care delivery.  

The platform is designed to streamline facility operations while freeing staff to focus more on direct patient support.

Reducing administrative workload is a key priority, said Geiger. VA administrators field frequent requests from Congress, veterans and other organizations, often requiring time-intensive data collection and analysis.

“That’s a lot of time that somebody takes to investigate. But if I had the data sitting somewhere, and I had the ability to reduce even two hours of that person’s time, that’s two hours that person can focus on hospital operations and improving processes and workloads that impact that facility,” he explained. 

Smart Tools for Informed Decisions 

Using Slack as an agentic operating system enables AI, human users and enterprise data to operate in a shared environment, transforming how employees manage services and operations, said Paul Tatum, executive vice president of global public sector at Salesforce.

For example, when facility metrics identify potential issues, the system automatically gathers the right experts in Slack, provides situational context and accelerates problem solving. This allows VHA leadership to focus on strategic decisions while AI manages routine coordination through a connected performance management layer, Tatum said.  

Geiger said Slack’s value lies in its ability to integrate across systems.

“It’s a translator of information. That’s why we’re using it,” he said.  

Because the platform is data-agnostic, it can connect disparate systems, including electronic health records and operational tools, enabling more seamless adoption of future technologies.

“It’s a system that, when I’m gone, should still be in place and be able to carry us into the future to be able to work with new adaptations of technology,” he said. 

The Slack-based agentic AI system allows the VHA to: 

• Provide a single front door for staff: Instead of logging into multiple legacy systems and applications, staff use Slack to access facility metrics and patient trends as part of their daily workflow. This allows them to collaborate in real time and take action without switching between systems.  

• Enable automated swarming: When certain metrics, such as wait times or patient satisfaction, cross a vulnerability threshold, Slack automatically creates dedicated channels, pulling in medical center directors and subject matter experts to swarm on the issue. Slack AI then summarizes context and highlights relevant information to speed a resolution.  

• Capture AI-powered context: Slack AI summarizes long chat histories, identifies areas needing urgent improvement and highlights promising practices from similar past incidents to provide improved care.  

• Mobile field integration: Staff conducting site visits can upload real time photos and notes from mobile devices directly to Slack. This data is immediately synched with VA headquarters to eliminate information delays.  

• Build institutional memory: The connective performance management layer created by the system allows the VHA to develop a permanent library of best practices to serve current and future patient needs.  

Pilot Projects on the Horizon  

With the initial rollout of the system now complete, VHA is considering pilot programs, Geiger told GovCIO Media & Research. The pilots would connect the Slack infrastructure to VA Health Connect, the agency’s 24/7 virtual contact center, to bring interagency telehealth collaboration into the same AI-enhanced environment. This would allow teams to manage patient intake and triage at the speed of hospital operations.  

Geiger noted that the VHA will soon take another step towards implementing a tracking system for questions fielded to the agency. He explained that it can be difficult determining the intentions of some questions: “is it about mental health wait times, substance abuse or general mental health?”  

The goal is to develop an AI-based system that can identify a user’s question history and then infer an answer more quickly and consistently. Geiger noted that the VHA aims to implement this tracking system across its network. This will allow the administration to proactively track trends and identify issues as they arise, he said.