Records

A damning GAO report shows that after at least eighteen years and billions spent, VA and DOD still have not figured out a way to share patient files across agencies.

The Government Accountability Office (GAO) has long critiqued the project because efforts to unify the system resulted in billions wasted while VA engaging in duplicative efforts. These efforts started in 1998.

After years and billions spent, the GAO found that neither agency had a clue about what outcome they wanted or what goals to create when creating the interoperable system:

“Even as the Department of Veterans Affairs (VA) has undertaken numerous initiatives with the Department of Defense (DOD) that were intended to advance the ability of the two departments to share electronic health records, the departments have not identified outcome-oriented goals and metrics to clearly define what they aim to achieve from their interoperability efforts.”

RELATED: VA, DOD Blow $1 Billion With No Strategic Plan

Presently, VA is still struggling to even develop the way they plan to measure what their outcome should be. Does this make any sense? GOA stated:

“VA has established a performance architecture program that has begun to define an approach for identifying outcome-oriented metrics focused on health outcomes in selected clinical areas and has begun to establish baseline measurements.”

RELATED: Despite Billions Spent, VHA Still Needs IT Update

Can anyone tell me exactly what this means? It sounds to me like VA is still at ground zero for figuring out the relevant issues.

VA, DOD ELECTRONIC HEALTH RECORDS

The summary of the report continued:

“Following an unsuccessful attempt to develop a joint system with DOD, VA switched tactics and moved forward with an effort to modernize its current system separately from DOD’s planned acquisition of a commercially available electronic health record system. The department took this course of action even though, in May 2010, it identified 10 areas of health care business needs in common with those of DOD. Further, the results of a 2008 study pointed out that more than 97 percent of inpatient requirements for electronic health record systems are common to both departments. GAO noted that the departments’ plans to separately modernize their systems were duplicative and recommended that their decisions should be justified by comparing the costs and schedules of alternate approaches. The departments agreed with GAO’s recommendations and stated that their initial comparison indicated that separate systems would be more cost effective. However, the departments have not provided a comparison of the estimated costs of their current and previous approaches. Further, both departments developed schedules that indicated their separate modernization efforts will not be completed until after the 2017 planned completion date for the previous joint system approach.

“VA has developed a number of plans to support its development of its electronic health record system, called VistA, including a plan for interoperability and a road map describing functional capabilities to be deployed through fiscal year 2018. According to the road map, the first set of capabilities was delivered by the end of September 2014 and included a foundation for future functionality, such as an enhanced graphical user interface and enterprise messaging infrastructure. However, a recent independent assessment of health information technology (IT) at VA reported that lengthy delays in modernizing VistA had resulted in the system becoming outdated. Further, this study questioned whether the modernization program can overcome a variety of risks and technical issues that have plagued prior VA initiatives of similar size and complexity. Although VA’s Under Secretary for Health has asserted that the department will complete the VistA Evolution program in fiscal year 2018, the Chief Information Officer has indicated that the department is reconsidering how best to meet its future electronic health record system needs.

Here is a GAO table for some background on the project’s development over the years. Notice one thing, try to recall what tech was developed during the respective year and ask yourself, “If we could go home phones to cell phones to iPhones in 18 years, why can’t we get DOD and VA electronic health records systems to talk?” Check it out:

Initiative Year Begun Details
Government ComputerBased Patient Record 1998 This interface was expected to compile requested patient health information in a temporary, “virtual” record that could be displayed on a user’s computer screen.
Federal Health Information Exchange 2002 The Government Computer-Based Patient Record initiative was narrowed in scope to focus on enabling the Department of Defense (DOD) to electronically transfer service members’ health information to the Department of Veterans Affairs (VA) upon their separation from active duty. The resulting initiative, completed in 2004, was renamed the Federal Health Information Exchange. This capability is currently used by the departments to transfer data from DOD to VA.
Bidirectional Health Information Exchange 2004 This capability provides clinicians at both departments with viewable access to records on shared patients. It is currently used by VA and DOD to view data stored in both departments’ heath information systems.
Clinical Data Repository/Health Data Repository Initiative 2004 This interface links DOD’s Clinical Data Repository and VA’s Health Data Repository to achieve a two-way exchange of health information.
Virtual Lifetime Electronic Record 2009 To streamline the transition of electronic medical, benefits, and administrative information between the departments, this initiative enabled access to electronic records for service members as they transition from military to veteran status and throughout their lives. It also expands the departments’ health information-sharing capabilities by enabling access to private-sector health data.
Joint Federal Health Care Center 2010 The Captain James A. Lovell Federal Health Care Center was a 5-year demonstration project to integrate DOD and VA facilities in the North Chicago, Illinois, area. It is the first integrated federal health care center for use by beneficiaries of both departments, with an integrated DOD-VA workforce, a joint funding source, and a single line of governance.

DOD, VA RECORDS SHARING HISTORY

The GAO report further explains the history in more depth:

“Since 1998, VA has undertaken a patchwork of initiatives with DOD to allow the departments’ health information systems to exchange information and increase interoperability.6 Among others, these have included initiatives to share viewable data in the two departments’ existing (legacy) systems, link and share computable data between the departments’ updated heath data repositories, and jointly develop a single integrated system that would be used by both departments. Table 1 summarizes a number of these key initiatives.

“In addition to the initiatives mentioned in table 1, VA has worked in conjunction with DOD to respond to provisions in the National Defense Authorization Act for Fiscal Year 2008, 7 which required the departments to jointly develop and implement fully interoperable electronic health record systems or capabilities in 2009. Yet, even as the departments undertook numerous interoperability and modernization initiatives, they faced significant challenges and slow progress. For example, VA’s and DOD’s success in identifying and implementing joint IT solutions has been hindered by an inability to articulate explicit plans, goals, and time frames for meeting their common health IT needs.

“In March 2011, the secretaries of VA and DOD announced that they would develop a new, joint integrated electronic health record system (referred to as iEHR). This was intended to replace the departments’ separate systems with a single common system, thus sidestepping many of the challenges they had previously encountered in trying to achieve interoperability. However, in February 2013, about 2 years after initiating iEHR, the secretaries announced that the departments were abandoning plans to develop a joint system, due to concerns about the program’s cost, schedule, and ability to meet deadlines. The Interagency Program Office (IPO), put in place to be accountable for VA’s and DOD’s efforts to achieve interoperability, reported spending about $564 million on iEHR between October 2011 and June 2013.

“In light of VA and DOD not implementing a solution that allowed for the seamless electronic sharing of health care data, the National Defense Authorization Act for Fiscal Year 20149 included requirements pertaining to the implementation, design, and planning for interoperability between the departments’ electronic health record systems. Among other actions, provisions in the act directed each department to (1) ensure that all health care data contained in their systems (VA’s VistA and DOD’s Armed Forces Health Longitudinal Technology Application, referred to as AHLTA) complied with national standards and were computable in real time by October 1, 2014; and (2) deploy modernized electronic health record software to support clinicians while ensuring full standards-based interoperability by December 31, 2016.

“In August 2015, we reported that VA, in conjunction with DOD, had engaged in several near-term efforts focused on expanding interoperability between their existing electronic health record systems. For example, the departments had analyzed data related to 25 “domains” identified by the Interagency Clinical Informatics Board and mapped health data in their existing systems to standards identified by the IPO. The departments also had expanded the functionality of their Joint Legacy Viewer—a tool that allows clinicians to view certain health care data from both departments in a single interface.

“More recently, in April 2016, VA and DOD certified that all health care data in their systems complied with national standards and were computable in real time. However, VA acknowledged that it did not expect to complete a number of key activities related to its electronic health record system until sometime after the December 31, 2016, statutory deadline for deploying modernized electronic health record software with interoperability. Specifically, the department stated that deployment of a modernized VistA system at all locations and for all users is not planned until 2018.”

How many more billions should we throw at this thing?

Source: http://www.gao.gov/products/GAO-16-807T

54 COMMENTS

  1. Each of those itemized dates and events should be looked at as only sacrifices feeding the VA Black Hole Cookie Jar. If the VA **truly** wanted to match DoD and both have a state of the art electronic record and IT system, it would have happened as it has with most of the rest of First World Medicine and evolved to present technology. I actually believe it’s all a ruse for $$$$ and has been up to this point. Nothing else realistically makes ANY sense.

    The VA is more apt to have and operate the most high tech records shredders while operating an IT System that’s about as current as two cups connected with long pieces of string. BUT…those same employees will have the most current iPhones and Tablets no doubt for their personal use at the VA Meat Grinder.

    I firmly believe that the VHA views any streamlining of records and claims simply as digging into their performance bonuses and believe the VA fails with IT continuously because the VA sabotages the efforts in an endless loop…and long as the $$ continues to flow.

    It makes one wonder if the AFGE has issued a resistance to IT measure to all employees to keep those sacrifices freshly tossed into the VA Black Hole. Keeping the beast happy? Makes no sense unless you look at it from a Human Greed stance.

  2. After reading all this VA + DOD gobbley-goop, it reaks of high echelon personnel getting RICHER!
    Where the hell is all the taxpayers monies really going? In my opinion, it isn’t going to what it was intended!
    Isn’t that a federal criminal act?

    • Right-on, crazy elf!!! I mean, we have a probe going into the planet Jupiter and robots mapping terrain on Planet Mars….how the F*cK can it be so freakin’ hard for the VA and DOD to coordinate on one system and keep progressively up to date?

      How is it that another huge gov’t agency, Social Security Adm. (SSA), is able to operate a MASSIVE database, AND able to efficiently crosstalk to OTHER agencies…EXCEPT with the VHA?
      I ask because I know from those years I was making both my SSDI and VA Claims, I had to do almost 4x the work doing 2 claims because the VA *refused* to communicate officially, let alone fill-out required forms by medical *doctors*, and the SSA hands were tied because they simply do not or did not at that time, crosstalk and share info with the VA?
      I had to go back and forth between the two and my private medical specialists, as I was destitute at the time, health on downward spiral…this really happened to me and I know from website hadit dot com many other Vets experience the same…it’s the damn VA NOT communicating that’s another part of the delays…and the VA not even KNOWING how many Vets died while waiting on appeals or even initial claims….because the VA cannot be too bothered to talk to a national database and agency?
      By design. Sorry so cynical but greed makes people ugly.

      “gobbley-goop” is so right-on, elf! 🙂

  3. Still seems to be a hardware solution for a software problem which locks certain lobbyist’s companies into long term contracts. Uncle Sam doesn’t own the solution and cannot change contractors.

  4. RE: How many more billions should we throw at this thing?

    They will continue to do this as long as Congress lets them get away with it…

    • @Don

      “How many more billions should we throw at this thing?”

      If it’s up to VHA and VBA as much as they can squeeze out of the taxpayers! Congress needs to tighten up on these scumbag asswipes. It seems everyone is getting richer off the backs of the taxpayers. And the taxpayers just can’t understand why their paychecks keep getting smaller and smaller. Yet, many are working two to three jobs to receive what they used to get with one job!
      Plus, you’ve got people working say, 23-25 hours a week making minimum wage, not understanding the employer is now not having to pay for healthcare.
      Giving $15/ hr. for that small amount of hours, is not the answer. Giving an employee 40 hours, (full time employment), plus overtime, (time and half), like it used to be IS THE ANSWER!
      Remember those days!? I do!!!!!

  5. Before I forget, everyone be careful out there today.
    This “day of rage”, as BLM and other radical groups are calling today’s date, isn’t a time to place oneself in a precarious situation!
    I pray it doesn’t come about. Yet, with all the previous days, being as violent as they have been, just be careful out there!

    ————————————-

      • I am a medical marijuanna user. I am just loaded, but if those bastards come near me this here water pipe is gonna leave a mean looking bruise on their noggin!

        Better yet, this is premium Oregon hash oil. Legal. Cheap. Prescribed for PTSD and extremely effective….maybe the rage folks wont feel so enraged, like me as a PTSD patient, if I just let them whiff a dab or two? It yanks the carpet from under rage lolz.

        Semper Fi my brothers

      • Also a card carrying member of the reefer club. But why waste a good bong when you can keep a nice, sturdy, axe handle nearby ;). Besides, most quality glass is expensive.

  6. Y’all do know that BOTH data systems evolved from the same code; the VA developed the original MUMPS code and DoD ‘borrowed’ it after it looked like something they could use. Of course, DoD ‘modified’ it without input from VA and that’s where the problems started. Both systems moved forward over the years, with modification and improvements on both sides, widening the gap that programmers have been trying to close. There’s also egos involved; DoD didn’t want to change anything and the VA found that the changes DoD wanted them to do would cause them problems.

  7. The GAO is really stating something very simple; the VA and DOD systems are not compatible because nobody tasked with doing it cares or wants it. The AFGE only stands to gain as more and more money and people are thrown at any project. Any project that is mystiously not even in the conceptual stage despite decades and billions is really not a rocket science problem lolz.

    The problem exists because as long as the problem exists the need for an ever growinf AFGE membership to address the every growing problem is patently clear. When the morbidly obese leader of AFGE addressed his mostly morbidly obese membership who feared their food supply would thin them out said he would be kicking some ass if reform happens. I really doubt that chubby muffin could even find his own ass without a mirror, but my point is he clearly knew he wielded enormous power not consistant with physical prowess.

    Only a man arrogant enough to know he holds the reigns on billions of dollars of public spending via his leadership of those tasked to spend it would emit such noises from his pie hole.

    Mark these words well; as long as AFGE exists there will continue to be billions spent on thin air with absolutely, positively, not a soul on planet Earth that anyone can blame.

    I believe they cover this the first week in Union Tactics 101. It is an extremely simple gig to off, and the present state of affairs is my proof.

    • If it were the AFGE then it would be software and fixable. The problem is a hardware solution has been used for “private company” benefits. Not the AFGE.

      • with respect Lem, there is no problem at all.

        Merriam Webster defines “problem” for me like this;
        something that is difficult to deal with : something that is a source of trouble, worry, etc.

        As for me I am a fan of the idea that all men are created equal. For example, I believe that those employed at VA are just as capable as anyone else in the world of solving problems. So I assume that the “something difficult to deal with” part of that definition has already been dealth with because human spirit just cant resist a difficult challenge, inside or outside VA and time is the trump card to win a challenge and those cards have been played.

        From experience I can assure you that if VA determines anything at all is a source of trouble, from a fellow dissenting doctor right down to a homeless mental health patient, that they take SWIFT, decisive, ruthless, and cunning action to silence and solve the trouble. In this sense, it just doesnt seem plausible that VA sees this issue as trouble. Otherwise they would have found a way to destroy it. History is offered as proof.

        That sort of leaves us with the “source” part of the definition in problem doesnt it? I am not a linguist of any real cunning, as It just doesnt suit my taste, so perhaps some here could elucidate better?

        Tell me how the lack of an accomplishment or goal could be the source of anything? No fair using VA definitions here either, ok?

        My post was not speaking to any problem, it was speaking to the current solution implemented by humans with the same capacities as anyone else. I believe the source of the current solution is a brotherhood that has vowed to “watch each others back” according to their website.

        That slogan must be a source of comfort.

      • DENNIS WHAT YOU TRY TO DO TO IMPROVE HEALTH CARE IF YOU WAS SECRETARY OF VETERANS AFFAIRS ROBERT McDonald. …..why don’t you tell me who is Representative so I give my belief on improving Veterans Healthcare My Representative is Paul Gosar ……Semper Fi.

      • If I were Sec of the VA, as soon as I heard muffin butt declare he would kick my ass, I would have shown up on the AFGE Presidents front doorstep as fast as my personal Learjet would fly, coordibate a press conference to coincide with my arrival on the guys front doorstep, haul his muffin ass out into the street, and have a good ol time in front of the USA.

        Then, to justify the episode, I would immediately authorize VHA to care for him. I of course would not be held accountable for any wrongdoing because I would be a govt. employee and enjoy that same protection.

        So,
        i guess the short answer to you, is as Sec of he VA, I would have punched muffin butt in the nose on prime time tv. Mostly just to show I had a pair.

      • Lobbyists. That is the problem the VA hasn’t dealt with adequately. Thus you have a hardware solution to a software problem which ties the taxpayer’s pockets to a particular company.

        I don’t bother with long dissertations when the shorter simpler route suffices.

        Seems to me your response is a smoke screen.

      • Respectfully, a smoke screen would be a tactical deployment of a device brought to bear against and to impede the enemy from detecting movment and to provide cover for either advancement or retreat.

        For example, when VHA was presented with an OIG report in 2009 that a,Roseburg vet had committed suicide after being labelled violent and having all local care moved from Eugene, (his home) to Roseburg, (the home of the notorious Roseburg Disruptive Behavior Comittee), and identified that Rosebrg mental health had indeed abanbandoned him;

        Roseburg VHA “concurred” , and is “implementing policies to forge new coommunication pathways between departments.”

        Lem, that statement would qualify as a smoke screen. Why? Because it is a temporary use device of no substance meant simply to cover the tracks of a cowardly and sinister group in Roseburg known as the Disruptiv Behavior Committee.

        My comments on the contrary wold actually he considered a direct assault in a forum like this as my comments make patently clear my motives, methods, and intentions.

        VHA smokescreens do exactly the opposite. Thank you for taking the time to engage me in this discourse, and know,that if you are a vet are welcome in my foxhole. You put your back to this Marines back when the shit flies and we,may,perish together but thebastqrds better bring a lunch because its gonna take a while.

        I fight the VHA for one simpl reason; they are harmong American veterans, and if I do not,prsonally step up to the plate and take a swing Lem then who will? This is my mission statement.

        What is yours?

  8. My firm believe that all Veterans and Veterans Personal that worked for Veterans Affairs, VSOS, PLUS MEMBERS AMERICAN LEGION, ANVETS. DISABLED AMERICAN VETERANS
    and Veterans Medical Centers Personal their that we can get a hold of to tell them bug their Representatives and Senators to share their beliefs how to improve Veterans Healthcare especially HIRED AT LEAST ONE COSMETIC DENTISTRY THAT CAN FULL MOUTH OF IMPLANTS THAT TEETH CAN’T COME OUT DAY or NIGHT AT A VETERAN MEDICAL CENTER IN OUR GREAT UNITED STATES. .SEMPER FI. I DO I AM CONCERNED VETERAN. IF YOU DON’T KNOW WHAT I MEAN BY HIRED ONE COSMETIC DENTISTRY GET ON THE COMPUTER FIND CLEAR CHOICE TO SEE WHAT KIND OF DENTISTRY DO.

    • Yes! Regardless of the “Political Correctness Police”, with me having a very healthy portion of my ancestry of the Cherokee Nation, I can say that old saying of, “Too many Chiefs, not enough Indians”, as it totally applies with the VA.

      However, the way the VA operates, they would spend a few million or ten on a committee to appoint a study (more $), to only in the end advise the VA that they actually need MORE Chiefs, and according to 1975 data, had too many Indians, so of course, more $ more Chiefs, more corruption. And, by the way, that data could only be extrapolated from the VA’s yellow ticker tape records as that was the tech then and currently not compatible with the VA’s current 1985 Tech.

      ^
      I was typing how freaking silly those line item of YEARS in which the VA has totally resisted updating their own IT/Technology. The updates needed would only speed-up/slimline the process of all claims IF the Humans working at the VA magically grew a conscious and the AFGE were banished to police hell for Satan. (Satan outsourcing the AFGE….love it)

      Rant Out. In a mood. Is it January, 2017 yet? If it goes well, I think we will see a war to finally snuff out these terror punks all over the world and blast them into outer space. Yep. In a mood. Blocked in the hot roadway while listless, lazy protestors were blocking traffic ramp…yep, in a mood.
      Rant finally out.

      If the VA had accountability, they would find a way to use it as bathroom tissue/toilet paper.

      • @namnibor

        I take it y’all had protesters up in Ohio today.
        We had them here in Brevard County at around 6 pm est.
        The news isn’t broadcasting anything yet!
        Will let y’all know when it is!

  9. Hey Elf,

    How about the coup against the government of President Recep Tayyip Erdogan today?

    That puts what is it hundreds of nukes in the Turkish Military’s hands from our NATO storage facility there?

    Not to mention all the PGM-19 Jupiter medium range ballistic missiles we supplied the Turkish military.

    Guess they should not have let all those border jumpers in.

    • In light of Cold War and current stuff, those are not things you should really be typing, regarding resources as such. Just saying, unless you really like men in black showing up or these terror freaks learning bits here and there in offensive web browsing…just saying. In all due respect.

      • Namnibor,

        I do appreciate the heads up and concern. The information is currently public knowledge.

        Also want to point out that this Coup has been bought and paid for through the Clinton Foundation. The man behind the Coup is Fethullah Gulen and his connections to Hillary are spelled out in several recent articles written by Chuck Ross over at the Daily Caller based on recent release of one of Hillary’s emails.

        “New ties emerge between Clinton and mysterious Islamic cleric”; July 13,2016 by Chuck Ross at the Daily Caller

        “http://dailycaller.com/2016/07/13/new-ties-emerge-between-clinton-and-mysterious-islamic-cleric/”

        “Followers of a mysterious Turkish Islamic cleric have donated heavily to hillary’s campaign and family charity “; 11/22/2016 by Chuck Ross The Daily Caller

        “http://dailycaller.com/2015/11/22/followers-of-a-mysterious-turkish-islamic-cleric-have-donated-heavily-to-hillarys-campaign-and-family-charity/””

        Apparently the Coup has been successful and Erdogan is in route to Germany for Political asylum.

        “How Germany-Turkey discord could damage NATO alliance” published July 12, 2016 in the Turkey Pulse

        “Anybody who thinks Turkey needs Europe more than ever to extricate itself out of its diplomatic isolation would be misguided.”

        If there is one unequivocal consequence of Turkey’s recent dual reconciliation with Russia and Israel, it is enhanced self-confidence to stand up to the European Union.

        “http://www.al-monitor.com/pulse/originals/2016/07/turkey-germany-incirlik-base-discord-damage-nato-alliance.html”
        ~
        ~
        Guess I should also point out that it is Germany that is providing the security at Incirlik Air Base where the nukes are stored. Also aided by our good frei-emenys from Saudi Arabia.

      • When a coup of a well established sovereign nation takes place it means that many years of politcal maeuvering, logistics planning, military recruitment, training, espionage and so forth have come to their fruition.

        History shows that the United States is likely involved at every level both overtly and covertly right down to the office supplies the coup leaders order from Staples. It will take a minimmum of 16 years to declassify any involvement the US has in the matter and then ONLY if the information is not still deemed potentially damaging to the United States.

        I have zero doubt that the coup option has been in play for this little country for some time and I also have little doubt that the tangled web of dependencies and side deals and trades for this is more complex than my own ability to unravel.

        This coup is no surprise to those who are running our national security. I am confident that the matter will not impact my safety. It might scorch big areas of the planet but likely only if that was the plan all along.

      • Oh and Namnibor,

        Just so happens U.S. Secretary of State John Kerry happened to be in Russia visiting with Vladimir Putin during this Coup.

    • The joint U.S.-Turkish Military Base at Incirlik, located in Adana, and other outlying bases have gone to “Force Protection Condition Delta.” According to U.S. military documents, Force Protection Condition DELTA dictates all missions halt except base security.

      U.S. and NATO aircraft have been diverted to bases outside Turkey and Greece and Iran are on alert.

      I truly hope this isn’t another Monty Python maneuver like they pulled in Iraq. Where Isis attached a major city and forces were told to lay down their weapons and leave the more than 300 Humvees and run away. Leaving the weapons and Humvees for Isis.

      Certainly seems like it might be heading in that directions with what is happening at the Base at Incirlik.

  10. At the v a its a 50/50 chance. Some good people,,some bad . Some will do everything to help you ,but then there’s the other sibe.go to this office ,,,o call back for a op ointment..but don’t call to soon to make it there is a window, and if you miss it ,you have to call agen in a mouth . , we can’t make it to erley . Why .just not don, well for get it . I know this .it happen to me .once in 1975///// and now last year. The V A is like a game show !spin the wheel see what you get . I gave up till 2011. Then ,the same.

  11. On CBS right now.
    The Turkish military coup is underway. Shots being fired.
    Here’s an interesting fact. Kerry, while there, bragged about how he is bringing in more Muslims to America, 6 fold!
    CBS just said “Kerry calls for stability!” Because the current Turkish government is an ally of the US.

    How much is true? IDK?

    And yes, nukes could be in Turkish hands.

    I would believe what “Infowars.com” reports over what our MSM reports!

    • P.S.
      On June 29, 2016 – “The EU was in talks with Turkey to join the EU!”
      Something was also discussed about how ISIS may use this as a way to infiltrate the west!
      ISIS does have a few “Passport Machines”! So, maybe that’s the reason behind this?!

  12. The Commission on Care recently released their finally report on Veterans Health Cares needed changes. Recommendation #7 is on the needed charges that are recommend for Information Technology at the VA.

    Recommendation #7: Modernize VA’s IT systems and infrastructure to improve veterans’ health and well-being and provide the foundation needed to transform VHA’s clinical and business processes.”

    The Commission Recommends 2 primary changes:

    1. “VHA procure and implement a comprehensive, commercial off‐the‐shelf (COTS) information technology solution to include clinical, operational and financial systems that can support the transformation of VHA as described in this report.”

    2. “VHA establish a Senior Executive Service (SES)‐level position of VHA Care System chief information officer (CIO), selected by and reporting to the chief of VHA Care System (CVCS) with a dotted line to the VA CIO. The VHA CIO is responsible for developing and implementing a comprehensive health IT strategy and developing and managing the health IT budget.”

    The report details some of the existing problems with the current IT system used within the VA health care system.

    One of the primary existing problem is that the VistA system has been customized across the board at each of the Health Care facilities managed by the Department of Veterans Affairs.

    The end result is that there are now 130 different versions of VistA implemented in the system. So any updates or modifications to the system as a whole requires reprogramming all 130 different versions.

    A good example of what this means is the Windows operating systems which has been upgraded 42 times since it was first released in 1985.

    Starting with Windows 1.0 to the latest upgrade to Windows 10. The upgrades have been to take advance of advances in technology and methodology used in IT.

    If you take a program written in Windows 10 and want to run it on a computer operating with Windows 1.0. It would take substantial modifications to the computer running Windows 1.0 also substantial modifications and reprogramming of the Windows 1.0 operating system to enable the program to run.

    The cost of modifications to the computer and the cost of modifications and reprogramming the Windows 1.0 operating system to run the program would cost at least ten times the amount it would cost replacing the system with a new computer and installing the Windows 10 operating system to run the program.

    Now consider that VistA has been in use at the VA since before 1985 and originally designed to run on computer technology in use before 1985. The cost associated with any updates or changes to the current VA system includes adapting those changes to 130 different versions of the VistA system and the cost of updating the computers that are running it.

    If followed the Commission’s recommendation to “VHA procure and implement a comprehensive, commercial off‐the‐shelf (COTS) information technology solution to include clinical, operational and financial systems that can support the transformation of VHA as described in this report.” Is the best bet over trying to upgrade 130 different versions of VistA for every change.

    It would also give the VA the fully functioning software now not 20 years in the future when all of the programming and modifications are completed. Also would provide the standards used for interoperability that is sadly and expensively lacking with the current system.

    “https://commissiononcare.sites.usa.gov/files/2016/07/Commission-on-Care_Final-Report_063016_FOR-WEB.pdf”

    In regards to the second recommendation to establish a Senior Executive Service (SES)‐level position of VHA Care System chief information officer (CIO).

    One of Ben’s prior articles was about how the CIO misused funds from the Medical budget to provide advanced IT gadgetry and commission the production of software to run that gadgetry using funds that could only be used for Veterans health care.

    I think that does demonstrate a need for a separate VHA Care System chief information officer (CIO) to prevent further misappropriations such as that.

    • On this you know what you are talking about Seymore. On Turkey you have little knowledge and your source is really suspect.

      • Hey Lem,

        Thank You for the acknowledgement on the subject relating to the VA and thank you for your opinion of my knowledge about what is going on in Turkey.

        Might I ask what it is about my knowledge about what is going on in Turkey you feel is incorrect?

        You may want to read the articles by Chuck Ross on Hillary’s connection to Fethullah Gulen I referred to in my comment. Also do a Google News search on the name Fethullah Gulen. Now that it is public knowledge that he is the man behind the Coup.

  13. Mr. Donald Trump was just on national TV LIVE!
    He’s introducing Gov. Mike Pence as his running mate!

    He went through many topics. The one issue that stood out for me was, he called the Veterans Administration “CORRUPT!” He spoke the truth. He didn’t speak of the AFGE. Yet, everyone knows they are the reasons behind why VA employees will NEVER be held accountable!

    I think the time, 20 Jan. 2017, will come when Cox will feel like leaving America.

  14. To 91Veteran, namnibor, Seymore Klearly and all.

    During the committees question and answer session of DOJ Lynch, on July 12(?).
    Rep. Ms. Walters began asking DOJ Lynch questions concerning the VA.
    It’s on Utube. Published on July 12, 2016 on Utube.

    Title to Google:

    “Rep Ms. Walters: Switched-it-Up to UNANSWERED Questions About VA Wait Times!”

    Y’all need to see this B/S from Lynch! Lynch actually said only one person “…in Georgia…” was fired.
    Yet, she couldn’t give any further details. Because there are continuing investigations! How’s that for sandbagging!?

    • Hey Elf,

      Good post. In the video I like how Lynch claimed not to know how many times the DOJ choose not to prosecute VA Employees.

      Also wanted to point out a good article about a blast this evening over in Syria. It includes Video. Certainly looks like a tactical nuke going off.

      “Large explosions at Assad defence factories in Aleppo”, published Sat, July 16, 2016 – 5:17pm EDT.

      “http://bnonews.com/news/index.php/news/id4905”

      Certainly looks like we might be seeing more explosions like this in the future.

  15. Hey Seymore

    Here’s a great video to watch. Even if it was taped on Feb. 24, 2013, it’s still relevant today. Plus, there are lots of politicians who should be ashamed of themselves.
    There are 2,359,161+1 views so far.

    Title;
    “Best 7 minutes on Gun Control I Have Ever Seen!”

    Watch the politicians laugh, when the ‘Second Amendment’ is “defined” as to “WHY” the “Founding Fathers” wrote it!

    ————————————-

    This one comes in at a close second, when someone is trying to get a point across to stupid politicians!
    Published on Jun 30, 2013
    2,366,237+1 views
    Titled;
    “Probably the Best 2nd Amendment Speech Ever!”

    ————————————-

    Lastly, published on Feb. 1, 2013
    With 2,859,900+1 views
    Titled;

    “The Most Honest Three Minutes In Television History!”

    All three of these videos should be watched by all Americans! Maybe they might just learn something!

  16. For y’all to Google. It’s out today. Titled;

    “Evangelicals back Trump; atheists support Hillary, Pew survey finds”

    Published July 17, 2016 by “1776 Coalition”

    It’s a very interesting article. This shows just how far the Democratic Party has not, and will never, embraced “God’s Will”!
    What’s it going to take for Americans to wake up?

    • Hey Elf,

      They might wake up in December after the election and Obama issues a Presidential Executive Order, in the name of political correctness, to change the term on all US Currency from “IN God We Trust” to “In Allah We Trust”.

      After all he wouldn’t want all of his Islamic Fri-enemies in the middle east holding American dollars to continue to go against the Quran.

      Also Elf enjoyed the Videos you pointed out in an earlier post. Here is one on the same subject.

      “George Carlin “The American Dream” Best 3 Minutes of His Career”

      “https://www.youtube.com/watch?v=rsL6mKxtOlQ”

      • Seymore, have you read, on “WND”, where France “… has declared war on ISIS!” They’re dropping bombs in response to what happened Thursday in Nice!(?)
        Now my question would be. Since France is part of NATO, does this mean the US and other NATO partners will have to declare war and help France?
        Or, are we going to let France go it alone?
        Lastly, why is Turkey an ally? Isn’t it true Turkey has, especially in the past decade, gone over to being a Muslim nation, under their current administration?!

      • France would have to either be incapable of requesting treaty assistance or formally request treaty assistance to invoke our allegiance to their cause.

        France is about the size of my home state. They are a mouse. As I recall they withheld support in my life for our efforts at stopping terrorism. Perhaps it is the severe PTSD diagnosis that makes me seem so cold, but they were warned at,the time that appeasement would only invite the infection to someday thrive on their own soil.

        There is no doubt that unless the infection is halted, one of them that is already undergoing intensive, grueling, and methodical training with little food, water, or comfort in some God foresaken hole in the world will succeed in their mossion.

        One of them is already set to detonate the big one and go get his virgins. Nothing will stop him short of death. Soil will be scorched, and the center of world appeasement is bullseye for ground zero. Zero tolerance and aggressive deadly force applied with extreme predjudice is just not an optional course of action with these animals.

        We warned the French.

      • France is part of the coalition in the middle east that has been supplying arms to rebels and fighting against the Syrian Government.

        France has been involved with the War on Terror from the start. So far all the War on Terror has done is topple elected governments in Iraq, Afghanistan, Libya … and are trying to topple the elected government in Syria.

        Recently they even sold several aircraft carriers to Egypt that are being used in the war of Terror in the Middle east.

        They have been bombing in Syria as far back as September of 2015.

        That is why France is a target. Although if anyone only relies on Main stream media which makes it appears that France is a country being victimized by Terrorist. They are a target for a reason.

        Oh and they are not a target because some one didn’t like a Charlie Hasbro cartoon published in a magazine.

        As far as Nato and Frances declaration they have been involved since the US declared the War on Terror.

        As far as Turkey, the US was supporting the other guy in the last election there.

        Sources:

        WND EXCLUSIVE “Irony: France supplied Islamists with weapons”
        Insisted guns were needed to fight against Syrian regime
        Published 01/10/2015

        “http://www.wnd.com/2015/01/irony-france-supplied-islamists-with-weapons/”

        “France-Egypt Mistral Deal: Cairo To Receive First Military Aircraft Carrier Following Agreement” 06/01/2016

        “http://www.ibtimes.com/france-egypt-mistral-deal-cairo-receive-first-military-aircraft-carrier-following-2376609”

        “Followers of a mysterious Turkish Islamic cleric have donated heavily to hillary’s campaign and family charity “; 11/22/2016 by Chuck Ross The Daily Caller

        “http://dailycaller.com/2015/11/22/followers-of-a-mysterious-turkish-islamic-cleric-have-donated-heavily-to-hillarys-campaign-and-family-charity/””

      • If France had supported the war on terror, then why did the lunch room used by the Congressional staff in Washington DC change the name of the menu item from “French Fries” to “Freedom Fries”? Lolz, as stupid as that seems they did just that to honor the day France bowed out of supporting the United States in the fight on terror.

        Only the Congress resorts to food fights in the lunch room still, but I suspect that for Congress to show such overt contempt at a so called close ally is representative of The People at the time.

        Unless you argue that the spuds were obtained without charge as a gesture of good will from the Nation Of Islam?

  17. Hey Elf,
    Regarding Tomah VAMC. You should remember that one of the Doctors there did blow the Whistle on the prescriptions practices of the Candy Man. He ended up being fired from the VAMC Tomah and took his own life. His name was Dr. Christopher Kirkpatrick.

    Senator Ron Johnson who has held multiple public hearings in Tomah concerning the VAMC and has been fighting for Veterans in Wisconsin. Sponsored a bill to protect federal whistleblowers from retaliation.

    In honor of Dr. Christopher Kirkpatrick action in trying to raise concerns about patients’ medications. The Bill is named “the Dr. Christopher Kirkpatrick Whistleblower Protection Act of 2015”.

    Although the bill has full support in both the house and the senate the Senate Minority Leader Harry Reid Blocked the Bill.

    The reason is simply because Mr. “I didn’t get the Memo” Russ Feingold is running against Senator Ron Johnson.

    Reid blocked the bill so Johnson cannot state it was an accomplishment. Fucking Reid and Feingold playing election year politics with Veterans Lives.

    Hey you AFGE employees. How to you feel about Reid and Feingold stiffing your Union. A bill that would not only help Veterans but also protect AFGE employees who blew the Whistle gets blocked so you will vote for Mr. “I didn’t Get the Memo” Feingold.

    Hey AFGE Members Don’t forget to follow your leader would want you to get all confused and vote for some one who is trying to protect you.

    Sources:

    “Harry Reid blocks Ron Johnson’s Whistleblower protection bill” Bill Glauber, Milwaukee Journal Sentinel July 15 2016

    “http://www.jsonline.com/news/statepolitics/harry-reid-blocks-ron-johnsons-whistleblower-protection-bill-b99762461z1-387015281.html”

    “For one whistleblower, getting fired was too much”, Donovan Slack, USA TODAY 12:07 a.m. EDT April 12, 2015

    “http://www.usatoday.com/story/news/2015/04/12/va-whistleblower-killed-himself-after-dismissal/25587367/”

    • I would say that AFGE members by virtue of just their membership are not the source of evil all and most I know realize full well the agency is corrupt just as most realize the sun rises and sets.

      The source of the evil is not the membership per se, it is the implementation of any union that enjoys protection only offered to foreign diplomats and govt workers. One quarter million workers who work by a different set of rules than everyone else in the land.

      The evil just manifests in AFGE, and the reault is a culture that honors and rewards behavior that perpetrates the union. A value system of deception will always evolve when there is reward reward for this behaviour, whereas a value system of truth can only serve to place the union under the control of The People. I can prove 18 different ways that given the option of controlling ones own fate over the option of allowing othher to control it, that it is the former option that ALWAYS manifests in humans.

      If AFGE went away tomorrow, any union that replaced it would self corrupt immediately. AFGEmust be neutered, but I am loath to discard the alliance of their individual membership so readily. Those people are in a position to make the choice, and let The People decide by blowing whistles. VA will let them die at their own hands, or destroy their careers or God knows what vengence sure, but some will choose a fate individually that honor that Pledge they learned in 2nd grade. Most will not and no fault of theirs, but some ally with the cause.

      • Dennis:
        Sorry to disagree with you on one point.
        I believe more VA employees enjoy the protection of AFGE than what we know. The reason is simple. Most VA employees are brain dead. Because, IF they truly believed they were there to help veterans. There would be many more whistleblowers standing tall.
        Since there are so few coming forward, it is easy to deduce the majority don’t give a rats ass about veterans. All they care about is their fucking paycheck!

        ————————

        @namnibor, Seymore and 91Veteran

        This just out from ‘WND Front Page”
        “War on Police”
        Titled;

        “3 Baton Rouge Officers Shot Dead”
        “Multiple injured – manhunt underway”
        (W/Video)

        Updated : 07/17/2016 @ 2:03 pm

    • Why doesn’t chat about the Prescott,Arizona Medical Center okay I will why no VA Medical Doctor or Mental Health Provider talk to you if they made a Medical Mistake.

      • I think it’s a BOT. Gooblygop non-germane comments like the last few. I will admit if wrong, but patterns are kind of my thing. VA BOT.

  18. Hey, y’all. Here’s a brand new video out by Judge Jeanine Pirro on Utube!
    titled;
    “Sheriff David Clark & Bikers For Trump Talk Security For the Trump Convention”

    Published on July 17, 2016.
    “Bikers will be on patrol with police!”

    If you’ll remember, over 600,000 showed for the “Patriot Ride” to Washington recently. Showing there support in bringing home “POW/MIA”s.
    According to the National Record, there are millions of bikers in America.
    I think there will be some violence at the convention. It won’t be started by the Trump supporters!

    Watch the video!

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