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Data Strategy is Essential for VA’s Ongoing Modernization

A cohesive data strategy will guide both health records modernization and improvements in lifelong care.

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The Department of Veterans Affairs is developing an agency-encompassing data strategy that will be used to guide both its health IT and patient care reforms.

Speaking at the FCW Data Analytics and Smart Strategies Workshop, VA Chief Data Officer Kshemendra Paul outlined both the focus of VA’s data strategy, as well as its foundational importance in guiding VA modernization going forward.

“There’s just a lot of work going on with data as a strategic asset, and the time is right to take us to the next level,” Paul said. “Taken together, the status quo is no longer an option across government.”

Much of this centers on what Paul broadly described as “strengthening VA as a learning enterprise,” or the process of using managed data to inform areas like operational decision-making, medical research, and refining veterans care to be more responsive to individual needs.

“What do I mean by learning enterprise? I’m talking about operational decision support. Using leading indicators and predictive analytics to support decision-makers to make better decisions and build continuous improvement,” Paul said. “We are in the business of serving veterans over their lifetimes. And so there’s an opportunity there to make stronger operational decisions based on data and analytics.”

As a primary focus, the VA is collaborating with the Defense Department to share vital information between the two agencies that helps inform a continuous program of more personalized care from the moment of enlistment to a veteran’s golden years.

“The veteran’s journey starts with servicemembers, and we’re working closely with our partners at DOD to develop a joint vision and strategy for data analytics between the two departments. The veteran’s journey starts at the recruiting process for servicemembers and continues then through their lifetime. Calibrating the veterans journey means really understanding the moments that matter along the journey and understanding what are the authoritative data sources that we need to use to make the best decisions and support those veterans in a moment,” he said.

The VA’s data strategy as it pertains directly to veterans care appears to focus on a more proactive approach to quality of life outcomes, particularly with an awareness of the foundations of both physical health and general well-being.

“We can build evidence-based policy that is increasingly proactive and oriented toward the best possible outcomes for our veterans and servicemembers like increasing healthspan outcomes, improving their economic lifetime outcomes, and personal dignity as measured by social connectedness,” Paul said.

Additionally, a cohesive and thorough data strategy also appears to be a foundation for motivating VA electronic health records (EHR) modernization and the cross-departmental collaboration between VA and DOD in implementing the unified Cerner EHR system. Paul also noted that the sensitivities of maintaining the extant Vista system and ensuring a certain continuity of operations has helped inform a more rigorous and focused data management strategy as well.

“Electronic health record data syndication represents the return path into VA from Cerner to support enterprise reporting and analytic use cases. Because of the complexity of the implementation, we have a multi-year time period over the next five to eight years where we’re going to have dual operations where Vista is going to be active in some locations and Cerner in others. Operating VA was complex enough with just one EHR, and now we’re managing two. Syndication is part of the process for bringing data back so that we can have that enterprise view,” he said.

Paul also emphasized that the data strategy will help better prepare the agency’s response to public health crises, including the agency’s ongoing work on managing COVID-19 triage going into what appears to be an expected second wave of the pandemic.

“VHA is the largest integrated health care system in America, and there’s a lot of operational concerns about care capacity. So the patient journey involves looking in aggregate at trends on population health related to whether it’s COVID or other diseases, and determining the queuing that comes with that,” he said.

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