Dr. Michael Kussman, undersecretary for health at the Veterans Health Administration, has resigned, effective in 30 days, well-placed sources have told me.
Last month, Kussman wrote a memo detailing the near collapse of an eight-year, $167 million effort known as the Replacement Scheduling Application Development Program.
Kussman said in the memo to Stephen Warren, the VA's acting chief information officer, that the patient scheduling program, in the works since 2001, "still has not developed a single scheduling capability it can provide to the field, nor is there any expectation of delivery in the near future."
The suspension in developing the application, Kussman wrote, is "significant and likely to generate intense congressional and Office of Management of Budget interest," Kussman said. "This is also of concern . . . because of the numerous representations of clear progress we have been making, not only to Congress and OMB, but more importantly to our health care providers, who are eagerly waiting for this capability."
Kussman also dealt with one key issue in his memo that has nothing to do with patient care or safety, but a lot with developing bureaucratic cover: "Finally, we need a clear communication plan for how we tell the story both inside and outside VA," he told Warren.
That communication plan obviously failed, as the memo was leaked to Nextgov before the VA and VHA could notify key congressional Committees. Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, was miffed he had to find out about the patient scheduling debacle in the media, rather than from the VA.
I'm told that Kussman, who is a holdover from the Bush administration and was slated to leave office this summer, became the fall guy for the patient scheduling mess -- and wasn't helped at all by some of the frank language in the memo.
When VA Secretary Eric Shinseki learned of the problems with the program, he told staffers to give him a comprehensive review by Thursday, April 9, and planned a congressional briefing for Friday, according to internal memos.
COMMENTS
This is a retired Brigadier General. Maybe now the truth about the VA will come out. He does not need to be the fall guy. I would have left yesterday. Maybe now "he" will restore some honor into a system he also protected. I am glad he left, maybe now he wil shed some light on a defunct system.
Deborah Hibbs 04/30/09 06:35 pm ET
Nothing new. . . Take it from someone who worked for the VA for several years. If you think the scheduling package is bad you should understand the VA still does not even know how many veterans it serves. The VHA keeps providing policies and mandates such as the use of the Patient Care Management Module (2004/2006) that several facilities have never implemented. It's truly a shame. I know that there are many health care providers who work for the VA really care about veterans and for the most part try to do a good job. The executive branch however, seems to function like a bureaucratic cancer made up of career-oriented (certainly not-patient-centered) people who get recycled from VISN to VISN so that nothing ever really changes.
Aleesa M. Mobley 04/21/09 08:24 pm ET
This has NOTHING to do with the care a person recieves. NOTHING to do with claims or the process. Rather everything to do with effective efficient scheduling and administrative record tracking of the patients and the internal billing process. It's IT related, There is a process that has been working since the early 80s not a great one, needs updating no doubt.
Does that make what happened o.k.? Absolutely not! Yes people should be held accountable. But most likely those people are no longer at CO with a new administration. My guess is the people that actually knew the code and how to program were actually pulled to other projects. The team assigned this project should be investigated to see what the heck they actually accomplished. Maybe dump the project for now, by re-organization they can eleminate people thru the RIF they are probably worthless anyway seeing as they didn't accomplish the task. But think about all the changes in the last 4yrs they have been massive with the current OIF/OEF yes people even IT is effected by this. I see postings left and right for IT in the Field Offices and I agree with JB I'm sure there are people out there that know the code to give this package a great jump start. I also agree bringing in "new blood" from a non-va man pool that has absolutely no conception of Hospital or Military or the adm as well as medical record needs cannot effectively re-write the program and it is insane to think it would work. Half the problem with Gov is they don't hire until they are knee deep in trouble or they are already running behind. THEN it takes 6-9 mos to hire a darn person then another YEAR to train them. (Another area where governement could hire the Disabled that is very ABLE to work in this field and hiring much faster now thanks to Schedule A)
To do programs like this you have to learn about tons of others because it effects so many other packages. This isn't a simple patch but a very complex program. AND the current system in VA probably works much better then ChampVA simply because we require military information and Eligibility requirements that is not required by the ChampVA record system, unlike them VA is not an insurance. Our system is much more complex, it flows with other packages not just scheduling appointments in a VA record. And don't even mention DOD medical record.
BUT I take personal offense when people trash (because of personal bias) that the "VA system fails it's veteran population." I like many many others have dedicated years of service to provide excellant service to the patients in VA. My father served in Korea and my child in Iraq, they use VA and recieve far better care then if they went to a local hospital. Is the VA perfect? No but what business is absoluetly perfect? They all make a mistake at some point... Look at Dennis Quaid his twins were almost killed by error! Consider the size in one hospital, we see thousands of patients per year heck in one outpatient clinic they will see far more then a local doctors office. Because of our size, over 140 hospitals, we are easier to pick on, we adhear to far more stringent standards for accredidation then your average health care facilities.
Comments like some I see here so far, I sure hope you don't work for the VA system, who needs to be beside such a negative force of option. I'd love to understand your idiotic comment ..... "another confirmation VA is not for the veteran" explain HOW does the scheduling package relate to that ??? This money was coming out of the IT Budget for VA (at DC level) not the Medical Budget (at local level) where the money is to treat the pateints. With the dedication portrayed in how you must feel about your job maybe you should seek employment elsewhere because obviously you don't like the company you work for.
Moran 04/14/09 10:39 am ET
Just another confirmation that the VA is NOT for the veteran!
William 04/13/09 07:30 am ET
A friend of mine just forwarded this to me.
In the late 90s Peggy Hall and I advised VACO that we were going to re-write the scheduler, not because it didn't work, but because it needed a new interface. The VACO people loudly ordered that we were to do nothing. They were doing it.
The VA has managed to take itself back to the early 70s in organizational skills. There's a lot of "preferred" VACO/Headquarters policy that is basically disrupting the agency as a whole, again, not because of needed change but because of empire building.
$167 million dollars for no product sounds like the typical political appointee undersecretary type decision made "because business does it better." That is a highly debatable point. The VA tended to be 5 years ahead of any business/clinical application and one of the few successful clinical computing environments. I don't know of a private, proprietary clinical system that isn't being sued by their customer.
This problem is caused by political appointees, who are always a marginal, dangerous addition to any agency, the false concept that the private sector does it better, and administrations' drive to lessen government. Kolodner and Kizer are also to fault in this debacle by creating such a morass of complex jargoned "techno" policies and standards that it opened a huge orifice for the professional ambitious bureaucrat to drive a semi through. The current IT organizational split from the clinical side of the house is the result. That's where the VA IT is today. Dead in the water.
Because of that result, there are idle programmers at the field stations, functioning local applications that are being denigrated by the VACO folks because VACO says they are a security risk (no matter that the apps may have been functioning for years). Code is being reviewed by mandate by people in the new IT organization that 1) don't know code, 2) have never worked in a hospital, and 3) don't know why they were hired in the first place. I know 5 programmers, 4 on current salary as VA employees, who could update scheduling system in 6 months, without extra funding being applied, let alone the originator.
I started in the VA in 1971 when the VA was a literal top down organization with incredible failings in functionality. It has almost reached that year again, crossing that bridge to the 20th century and beyond...
jb
Jim Bell 04/08/09 10:03 am ET
Somebody has got to be held accountable at the VA for all the BS going on. Now when they start firing claim people at VARO for having too many remands & overturns, stuff will really begin to happen.
Dan Cedusky "ColonelDan" 04/07/09 10:30 am ET
At least - actual improvements at the VA. Who would have thought? Any veteran knows full well that the VA is not your friend.
Kathy 04/07/09 09:43 am ET
America and our veterans deserve better care and care management from the VA. Why doesn't the VA use a patient scheduling system similar to the one used for TRICARE patient appointment line; it seems to work just fine. Agencies need to stop wasting valuable time and taxpayer dollars trying to reinvent the wheel - (or pad the purses of failing contracts) when those assets could better serve our taxpayers and veteran. A large amount of blame has to go directly to the procurement office and the contracting officer's representatives. And what happened to oversight on the part of the IG? Sometimes more than one individual is responsible for negligence, waste, fraud, and abuse and more than one person should be held responsible.
Gayle Williams, MSG/USA (Retired) 04/07/09 09:25 am ET
This and the previous story (3/31/09) by Mr. Brewin are just the tip of the iceberg. They've stalled on the disability claims processing, they've stalled on revising the most insidious combined rating schedule ever devised, and they've stalled on so many other things that are detrimental to Veterans it is criminal. Yes, I did say criminal. Every top manager and deputy from every department, and every Regional Office and Service Center need to turn in their resignations immediately. The scandalous dishonesty and lack of ethics has cost the deaths of tens of thousands of Vets, with impunity. The Feres Doctrine needs to be overturned immediately and these people need to be prosecuted. That's the Bottom Line.
K9USAFRet 04/06/09 11:03 pm ET