Printer Friendly Page
LEADERSHIP AND TECHNOLOGY CENTRAL TO THE VA
TURNAROUND -- Commentary on the role of
Dr. Kenneth Kizer and VistA software.
Story here...
http://www.dmreview.com/article_sub.cfm?articleId=1070473
Story below.
---------------
Making IT Work:
By John Lee
Leaders at the level of executive sponsor consistently exhibit the
following characteristics:
* They hold themselves personally accountable for customer satisfaction.
* They hold themselves personally accountable for creating career
opportunities for the people in their organization.
* They have a proven track record of sponsoring initiatives that produce
measurable results for customers and internal staff.
* They have a proven track record of managing both formal and informal
teams to produce measurable business results.
* They lead rigorous review meetings to design, plan, implement and
review key initiatives and these weekly review meetings are focused upon
measurable progress toward measurable objectives.
* They can and will go get the money, the people and the approval for
anything that could substantially improve customer and employee
satisfaction.
* They say "I don't know" on a regular basis.
* They are often angry and vocal about things that don't work for
customers and employees, and they take personal and effective action to
fix what is not working.
Dr. Ken Kizer's work with the Veteran's
Administration (VA) hospital system is a case study in leadership, and
how a leader at the Executive Sponsor level can use technology to
engineer a transformation of an organization.
Leadership and Technology: Central to the VA Turnaround
According to an article in the May 11, 2006, edition of Fortune
magazine:
" . . . Tech is at the heart of the transformation. A networked software
program - dubbed Vista - runs a powerful electronic medical
record-keeping system that acts as the VA's brain. Through Vista,
doctors submit prescriptions electronically, minimizing errors that stem
from illegible handwriting. They are notified when their patient needs a
flu shot, a chest X-ray, or other follow-up care. (In a pilot program,
many vets also get reminders over home computers.)
"The improved care at the VA hasn't been lost on veterans. This year the
agency expects to treat 5.4 million patients, up sharply from the 2.9
million people it treated a decade ago. Customer satisfaction with the
veterans' health system, as measured by the University of Michigan, has
exceeded that for private health care in each of the past six years.
"'The care is second to none,' says Tom Bock, national commander of the
American Legion, the nation's largest veterans' organization . . . "
How did Kizer do it? Where others saw a hopelessly bloated and
ineffective government organization, Kizer said, "I thought that it had
great potential." One of the areas of greatest potential was in the
management of information, because the VA system administered its own
patient claims process and was not held hostage to a plethora of health
care insurance programs. In addition, over the years the VA information
technology staff had built a suite of programs to assist the staff in
making headway in the process of standardizing and digitizing patient
records and the patient care process. However, in 1989 only 169 of the
hospitals in the system had the Vista system with two dozen applications
running.
To make the Vista system really work, it needed to be enhanced and
expanded; to do this Kizer needed funding. He negotiated a special
arrangement with the Federal Office of Management and Budget that
returned any proven cost savings back to the VA. He then worked with
pharmaceutical companies and other medical industry suppliers to lower
the costs of goods and services sold to the VA - to the tune of hundreds
of millions of dollars annually. A significant portion of these savings
went into new Vista software applications, new computers at every VA
installation, and a network infrastructure that was fast, reliable and
had the bandwidth to support the upgraded infrastructure.
By 1999 Vista was up and running throughout the VA system. All patient
records are now held within a nationwide digital system and available
over secure Internet connections to VA staff members throughout the
country. This in a $1.9 trillion industry (accounting for 15 percent of
the U.S. gross domestic product) where 90 percent of the 30 billion
health care transactions completed every year are done by paper mail,
telephone or fax machine. This breakthrough in technology to take care
of patients has been done within a system that has kept the annual cost
per patient at around $5,000 over the past decade, while the average
American spends $6,300 each year.
The devastation wrought by Hurricane Katrina demonstrated the
possibility of digital health care record keeping: VA patients records
were intact and available throughout the United States, helping to
maintain service for people as they struggled to live in the path of the
hurricane or moved to other parts of the country.
In addition to the Vista system, Kizer encouraged individuals to come up
with solutions to technology problems and took the point of view and did
not pretend to have all of the answers. In 1988, during a regular review
meeting Kizer was told about an initiative at a VA facility in Kansas
that was reducing medication errors through the use of bar code scanners
to reconcile and verify that patients were receiving the proper
medications as prescribed. A nurse at the Kansas facility had observed a
bar code scanner in use at her rental car agency when she returned her
vehicle and wondered if such a system would work for the VA. Ken Kizer
went to Topeka, and what he saw there convinced him to explore the
possibility of expanding such a system for nationwide use. In less than
three years an enhanced system modeled on the one in Kansas was in use
throughout the VA hospital system.
The turnaround at the VA is proof that the right people and the right
technology can make a difference in any organization, public or private,
large or small.
...............................................................................
John Lee is a Director with Navigant Consulting Inc. and has 21 years of
experience in the information technology field. Prior to joining
Navigant, he was a manager with a Silicon Valley startup, spent eight
years with Oracle Corporation and founded an IT consulting firm. He can
be contacted at (314) 566-3603 or at
jlee@navigantconsulting.com.
---------------
Larry Scott
