Veterans Affairs 2023 Trends Include PACT Act, EHR Rollout

2022 was a year of massive growth for the Department of Veterans Affairs, expanding benefits eligibility to more than 3.5 million veterans following the passage of the PACT Act, improving veterans’ user experience with centralized applications, creating new workforce strategies to attract top talent and more.

Going into 2023, VA is leveraging that momentum to continuously improve veteran services.

Below are the top developing stories to watch.

PACT Act

President Joe Biden signed the historic PACT Act into law in August 2022, funding compensation and health services for more than 3.5 million veterans who suffered military exposure during service.

Since then, VA has received more than 212,000 PACT Act claims, the agency reported in December 2022. The new law provides VA’s Benefits and Health units with new funding to support claim processing and efficient benefits delivery to veterans. With the funds, VA is investing in a people, process, technology approach, bolstering workforce strategies and developing automated decision support tools.

On Jan. 1, 2023, VA obtained the authorities and capabilities to begin processing PACT Act claims.

“We at VA are ready to process these claims and deliver PACT Act-related care and benefits to toxic exposed Veterans and their survivors,” said VA Secretary Denis McDonough. “To all Veterans and survivors: don’t wait, apply now – we will get you the care and benefits you deserve.”

2023 Outlook

While VA is processing claims “faster than ever before,” according to McDonough, the agency is still preparing for backlog increases.

“We anticipate the numbers increasing as we’ve had a number of claims that we’ve had to hold. We haven’t yet had the authority to process the 200,000 PACT claims, and we’re actively working to encourage more veterans to file right now,” Senior Advisor for Policy, Performing the Delegable Duties of the Under Secretary for Benefits Josh Jacobs said during a December 2022 media roundtable. “The backlog is going to increase, but we’re prepared to tackle it.”

In 2023, VBA plans to expand use of automated decision support tools to extract information from veterans’ records to help with claims evaluations. As of December 2022, these tools have been utilized at eight regional offices, but VBA plans to expand to additional offices in the future.

VA Deputy CTO Zach Goldfine said he will work to expand automation efforts by consolidating veteran data across the enterprise and breaking down silos to quickly locate information related to benefits eligibility.

“We think there’s a lot of promise in expanding from just those couple of small sources and say, ‘well, we know that things might show up in this system and that system,'” Goldfine said in a November 2022 interview with GovCIO Media & Research. “VA is such a big organization and has built so many systems over the decades that it takes a long time to figure out what information is where, what information would be helpful in certain cases and to put it all together.”

VA: Health and Benefits Mobile Application

VA formally launched its mobile application, VA: Health and Benefits, in August 2022. The new app centralized veterans’ health and benefits information to streamline navigation of VA’s services.

“It’s designed to be a single secure platform that allows veterans to manage their services wherever they are, right in your right in your pocket,” Chris Johnston, deputy CTO of Digital Experience at VA explained during an August 2022 demo. “It’s a personalized experience for people to be able to do things like check the status of a claim, secure message your provider or find a facility.”

Through the interface, veterans can view and cancel health care appointments, view claims and appeals status, upload documentation, message their doctor, locate facilities and more. It also provides access to the VA Crisis Line.

Since its launch, more than 1 million veterans have downloaded the app, VA reported in November 2022.

What’s Next?

VA will continue to use human-centered design insights gleaned from customer feedback to improve the application functions. Developing a modern, mobile service offering will help the agency connect with younger generations of veterans.

“We’re very excited… to reach that younger population of veterans, which happen to trust us less,” VA Chief Veterans Experience Officer John Boerstler said in a November 2022 GovCast interview with GovCIO Media & Research. “Those younger Millennials, those Gen Z-ers, don’t trust VA as much as veterans over 40, 50, 60 and 70. So, how can we take the best practices for the older generations of veterans that love VA, that trust VA to deliver their care and benefits… to younger populations. I think digital mobile experiences is the way forward.”

As VA continues to build out the application, the agency anticipates adding new features in the coming year, such as refilling prescriptions, requesting appointments and managing payments.

Tech Workforce Modernization

Not only did the VA emphasize huge hiring pushes across VHA and VBA in 2022 to support PACT Act claim processing, but the VA’s tech unit developed new strategies to take advantage of private sector tech layoffs.

Top leaders at VA OIT emphasized a new, targeted approach to attract tech talent from the private sector to join the agency.

New recruitment programs, such as VA’s cybersecurity apprenticeship program, and incentives such as remote work and special pay rates for tech talent to incentivize people to join his team, VA Deputy Chief Information Officer and Chief People Officer Nathan Tierney said in a December 2022 interview.

CIO Kurt DelBene also said VA is implementing change management for its current workforce to make zero trust a mindset during GovCIO Media & Research’s CyberScape: Zero Trust event in September 2022. He believes security should be a part of an employee’s passion and inform everything they do at work.

“First thing we should do is get a workforce that fundamentally believes security is the most important thing,” DelBene said. “The people driving your system need to have a sense of what zero trust means to them. Designers and developers have to have that inherent thought that security is at the core of what they do.”

Stay Tuned For…

VA will work on an internal roadmap for implementing zero trust also using a zero trust scorecard in 2023, DelBene said. Key to this initiative is people.

“Another great thing about zero trust is you can create a scorecard of measures that kind of define how close you’re getting toward what you think your nirvana looks like,” DelBene said. “We also need people to be inherently thinking first from a perspective of vision and how the roadmap connects to a vision that’s in terms of the outcome for vets, their families and caregivers.”

Additionally, VA will make its own tech salaries more competitive with industry. VA partnered with the Office of Personnel Management (OPM) to create a special salary rate for IT specialists. The salary rate is still under review, but VA expects an answer by the end of January.

“If that is approved in January 2023, that affects over 75,000 federal workers that are IT specialists in 2210 series,” Tierney said. “I’m really happy about that because that’s been leading the charge in driving big change not only within the department, but also the federal government.”

Electronic Health Record Modernization

Over the past year, VA reorganized its EHR management and deployment schedule. These overhauls followed Oracle purchasing Cerner Corporation in January 2022, making Oracle Cerner the new proprietor of VA’s EHR software, Millennium.

Following challenges with outages and patient safety concerns, VA postponed its rollout schedule in June 2022. In a subsequent press release, VA reported “several additional technical and system issues” including challenges with performance, problems with patient scheduling, referrals, medication management and other types of medical orders that need to be addressed before the agency resumes its schedule.

“Right now, the Oracle Cerner electronic health record system is not delivering for Veterans or VA health care providers – and we are holding Oracle Cerner and ourselves accountable to get this right,” said Deputy Secretary of Veterans Affairs Donald Remy stated in the Oct. 2022 release.

What to Expect in 2023

To date, VA plans to resume its rollout in June 2023. As it makes system improvements, the agency’s primary focus will be patient safety.

VA will continue to work closely with Oracle Cerner to resolve issues with the system’s performance, maximize usability for VA health care providers and ensure veterans have access to an effective records system that supports their health care.

“We have to make sure that our physicians are not pressured and are not facing a system that ultimately makes their care unsafe,” VA’s Undersecretary for Health Shereef Elnahal said during DAV’s 2022 National Convention.

VA will focus on four primary components: change management, leveraging user feedback, holding industry partner Cerner accountable for system downtime and preparing for the next deployment.

“We are learning over time with each of these deployments,” Elnahal said. “Veterans should never, ever feel the impact of electronic health record change. That just should not happen. We need to make sure that our systems and our people are supported and trained so that care veterans are getting is not affected. That’s my commitment.”