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As the Department of Veterans Affairs (VA) continues mobilization efforts to support the COVID-19 pandemic, VA’s Office of Information and Technology (OIT) is partnering closely with the Veterans Health Administration (VHA) to ensure that Veterans continue receiving top-quality care. Thanks to the recent efforts of VHA and OIT’s Account Management Office (AMO), Enterprise Program Management Office (EPMO), and IT Operations and Services (ITOPS), one such successful collaboration enhanced the Consult Toolbox (CTB) to allow VA providers, clinicians, and support staff to prioritize appointment scheduling during COVID-19.

Consult Toolbox Enhancement:

  • Prioritizes appointment scheduling for Veterans.
  • Facilitates the return of normal patient care activities.
  • Completed in less than 10 days what would normally have taken six months.

Due to the pandemic, all non-critical and non-urgent in-person medical care was suspended to avoid spreading the virus. This resulted in cancellations and delays of thousands of outpatient appointments and elective procedures across VHA. Dr. Brian Hertz of VHA recognized the need to incorporate standardized language into the referral process and collaborated with Dr. Charles Demosthenes of the Office of Electronic Health Record Modernization to develop the COVID-19 enhancements to the Consult Toolbox (CTB).

Agile Framework – The Key to Success

Serving as the critical link between OIT and its business partners, AMO immediately engaged EPMO and ITOPS team members to obtain additional information on the desired functionality and efforts. With these goals in mind, the team began to work with VHA partners to ensure this emergency enhancement could be completed in a compressed timeframe.

In keeping with OIT’s agile methodology, EPMO and ITOPS team members developed an aggressive timeline that not only met the business need, but also removed potential barriers to deployment. The team prioritized the work over everything else, enabling what is typically a 6-month deployment timeline to occur in just under 10 days. To accomplish this, OIT leadership expedited the typical software delivery path and recommended that the functionality be added to the current version of Consult Toolbox.

The ITOPS team turned the update around in just hours instead of days. Once the product was ready, production Initial Operating Capability (IOC) began. Typical IOC testing occurs with 3-4 sites and three users per site; IOC testing for this enhancement included seven sites and over 45 testers.

“Consult Toolbox (CTB) enhancements related to COVID-19 provided a much-needed opportunity for outpatient care coordination. The ability to identify patient needs and match them with available resources has been crucial in ensuring patients receive timely care in an organized fashion. Collaboration with our colleagues from OIT in building, testing, and implementing was amazing and a true reflection of teamwork.”

~ Dr. Brian Hertz, Senior Medical Advisor, Field Based at Hines VA (Chicago)

The new tool rolled out at the seven sites and was monitored for 24 hours, then rolled out nationally and was deployed in record time. Typical duration is 30 days; this deployment was completed in only five days. This effort could not have been successful without the seven initial IOC sites: Salisbury, Fort Harrison, Salt Lake City, Madison, Puget Sound/Seattle, Houston and Tennessee Valley VA Health Care Systems and Medical Centers.

Alongside development and testing, VHA business partners were instrumental in developing and deploying critical training and communications related to the new feature. Through weekly communications calls staff members learned  how to capture COVID-19 patient scheduling information, as well as how to triage and prioritize Veterans with critical needs to ensure they were accommodated first.

As a result of the solid teamwork, the national deployment of CTB COVID-19 is assisting VA providers, clinicians, and support staff with tracking, triaging, and grouping new consults and canceled appointments to deliver the most clinically urgent care to Veterans more quickly. And its value won’t end after the pandemic has passed; CTB COVID-19 will facilitate the return of regular patient care activities when normal operations return.

This accomplishment was an exemplary effort between VHA’s Office of Community Care, Office of Veterans Access to Care, National Director of Gastroenterology, Office of Informatics, and OIT to identify and implement a solution that improves care coordination, increases efficiency for appointment scheduling, and ultimately improves the Veteran’s experience.

COVID-19 presents many challenges to VA — but just as many opportunities. Now more than ever, OIT is working shoulder to shoulder with our business partners to develop and deploy innovative IT solutions. The successful release of CTB COVID-19 not only showcases VA’s mission to care for Veterans, but ensures they continue to have seamless access to the care and services they deserve.

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