Reforms, restructuring at Veterans Affairs announced (US)

A new Secretary, but the same old process? New Secretary of Veterans Affairs (VA) Robert McDonald is quickly finding out that cleaning house at a government agency is not quite as straightforward as at Procter & Gamble, where he had been CEO. Since being confirmed by the Senate in late July, he has had to fight the fires of multiple scandals, beginning with the Phoenix VA ‘secret’ veterans care wait list leading to uncovering disastrous delays in care at VA regions across the nation. As of this week, and convincingly timed around Veterans Day, McDonald announced a reorganization of the VA to the Washington Post–a restructuring of the VA around the creation of:

  • A new customer service organization across the entire VA, headed by a “chief customer service officer” reporting to McDonald
  • A standardized regional framework meant to streamline partnering and coordination
  • Realignment of internal business processes into a shared services models to improve efficiency, reduce cost and increase productivity
  • Collaboration with partners to create a national network of Community Veteran Advisory Councils

Heads are rolling, but slowly. There are pending disciplinary actions affecting at least 35 employees and perhaps as many as 1,000 employees upcoming. In the past year, the VA put 6,000 of its 330,000 employees under disciplinary action, where administrative leave is the first step in a long and tortuous process of building a case. However, unlike P&G, a judge has to approve each and every single one of these–and this process is mandated by Congress. According to Fox 43 (below link), the Justice Department has also sidelined at least 17 referrals for prosecution out of 30 already submitted by the VA Inspector General.

To be expected in this atmosphere are voluntary high-profile departures of attractive candidates to other healthcare organizations. One of those departures impacts telehealth, as VA is still the largest single user of telehealth services, one of their few bright spots [TTA 15 Oct, 20 June]. The head of VHA Telehealth Services, Adam Darkins MD,  quietly left last month to become Senior Director of Medical Affairs and Enterprise Technology Development at Medtronic. He had been with the VA for over 11 years primarily as a Chief Consultant. His profile on LinkedIn notes that his area is “non-Federal healthcare”; however, it should be noted that Medtronic-owned Cardiocom is a VA telehealth contractor. Our own Editor Charles Lowe picked up the change earlier this week in a different context: Dr Darkins will be a speaker at the ‘Integrated Care’ RSM meeting on 24-25 November.

Himself a West Point graduate and a veteran of the 82nd Airborne with Ranger tab and Senior Parachutist wings (plus), Mr McDonald will not find leadership of the VA at this point in time quite as straightforward as a jump into a hot zone out of a perfectly good airplane. FierceHealthcareWashington TimesFox 43 Washington

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