VHA in Dire Straits

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http://www.y2ktimebomb.com/Washington/Misc/smith9926.htm Z writes:

I am a molecular biologist working in a Virginia medical research facility. My boss happens to be a higher up at the Veterans Administration Hospital in Hampton and is on site most of the week. We have been contemplating moving our laboratory to the VA site (which is a huge collection of buildings) so he can be closer to the lab and yesterday we toured the facility to look at the new lab. Just as we walked in the door, the Administrative officer was reading from a document with everyone gathered around about doing a Y2K ASSESSMENT! I asked her some questions such as "Is this the first that you've heard of this?" and "What's involved in the assessment?" She was absolutely CLUELESS! This "base" is HUGE, and they are JUST STARTING THE ASSESSMENT!

"Ok," I said, "what are they asking for?" "First," she said, "they are going to assess weather the physical plant (power, water, etc.) will withstand a date rollover." "What happens if it fails?" I asked. Again, she had no clue. She has to organize and administer the test. Oh man!

Anyway, this place is going down. From the condition of the buildings (not bad, but not great) and the fact that the person running the test has to teach herself all about this new-fangled Y2K business I have little hope that it can get remediated in under 200 days. Now I'm not saying that failure or collapse of this place is a national calamity or anything, but if this is any indication of how the "gubment" is running remediation, "I'm outta hea!"

Harlan Smith responds:

I have looked at this problem a little and so far, what I have seen lends credibility to this report -- a lot of credibility.

The VHA (Veteran's Health Administration) that runs VA hospitals has 1,100 individual sites to worry about.

See the following excerpts:
VHA's approximately 1,100 sites of care delivery have been organized into 22 Veterans Integrated Service Networks (VISNs). The VISNs are now the system's basic operating unit. (VA assets include 171 hospitals, 133 nursing homes, more than 600 ambulatory and community-based clinics, 40 domiciliaries, 206 counseling centers, 73 home health programs, and various contract treatment programs.)
There have to be 1,100 certificates of compliance submitted by August 1st, 1999, signed by the director of the individual facility and the director of the parent VISN.

Instructions for compliance:
VISN Year 2000 Activity Checklist Certification. This is a certification all facility and VISN Directors must sign and return to the Year 2000 Project Office by August 1, 1999, certifying that this process has been documented and reviewed.
Text of compliance certificate:

The checklist they are certifying to is a 10-page MS Word document.

Here is a sample of the 10 pages of questions from the above document:
Have you established a Y2K task force or working committee (e.g. risk managers, biomedical engineers, facilities managers, information systems directors, nursing administrators, materials managers, safety officers, and key clinical department heads)?

Does this committee meet at least monthly?

Have written minutes been maintained for each meeting of the committee?

Has Y2K been given high priority for resource allocation?

Have you incorporated Year 2000 certification requirements in the purchase or maintenance of your equipment and systems?

Have you documented and kept on file compliance information received from manufacturers?

Do you have a readily available inventory of systems at each hospital and does it include all systems/components that contain digital controls?

Does your inventory include equipment in storage, out for repair, or being repaired internally?

Does your inventory include equipment that is rented or on loan to others?
Everyone will likely put to together a different picture in their mind from this information, but based on relevant testimony to Congress on this issue (from Joel C. Willemssen)...

In brief, VA continues to make progress in its Y2K readiness. However, key actions remain to be performed. For example, the Veterans Benefits Administration (VBA) and Veterans Health Administration (VHA) have not yet completed testing of their mission-critical systems to ensure that these systems can reliably accept future dates -- such as January 1, 2000. Also, VHA has not completed assessments for its facility systems, which can be essential to ensuring continuing health care. In addition, neither VA nor FDA have implemented our prior recommendation to review the test results for biomedical equipment used in critical care/life support environments. Further, VHA's pharmaceutical operations are at risk because the automated systems supporting its consolidated mail outpatient pharmacies are not Y2K compliant. Lastly, VHA does not know if its medical facilities will have a sufficient supply of pharmaceutical and medical-surgical supplies on hand, because it does not have complete information on the Y2K readiness of these manufacturers. It is critical that these concerns be addressed if VA is to continue reliably delivering benefits and health care.

VHA's Y2K program likewise had areas of concern. For example, although VHA's medical facilities had hospital contingency plans, as required by the Joint Commission on Accreditation of Healthcare Organizations, they had not yet completed Y2K business continuity and contingency plans. To address these areas and to reduce the likelihood of delayed or interrupted benefits and health care services, we recommended that VA:
  1. Reassess its Y2K mission-critical efforts for the compensation and pension online application and the Beneficiary Identification and Record Locator Sub-System, as well as other information technology initiatives, such as special projects, to ensure that the Y2K efforts have adequate resources, including contract support, to achieve compliance in time;
  2. Establish critical deadlines for the preparation of business continuity and contingency plans for each core business process or program service so that mission-critical functions affecting benefits delivery can be carried out even if software applications and commercial-off-the-shelf (COTS) products fail, including a description of resources, staff roles, procedures, and timetables needed for implementation; and
  3. Ensure rapid development of business continuity and contingency plans for each medical facility so that mission-critical functions affecting patient care can be carried out if software applications, COTS products, and/or facility-related systems and equipment do not function properly, including a description of resources, staff roles, procedures, and timetables needed for implementation.
VBA and VHA plan to conduct end-to-end testing between now and this July. VBA is defining end-to-end testing as verification that core mission-critical business functions, including benefit payments and vendor and payroll payments, process correctly. The interfaces between VBA's benefits system and Treasury's Financial Management System are to be tested in May. VBA also plans to test transactions that interface with VHA systems, such as information related to veteran eligibility. VHA is defining end-to-end testing as verification that core mission-critical business functions, including patient-care transactions and vendor and payroll payments, process correctly. Once these tests are completed, VBA and VHA plan to conduct a "business process simulation" during the July 4, 1999, weekend. This simulation of day-to-day work at VA is to include users at the VBA regional offices and VHA test laboratories, who will simulate various transactions and process them through a set of interrelated systems necessary to complete a core business function. VBA expects to pretest the business process simulation during May.

Assessment of VHA's Facility Systems Not Yet Complete

VA's facility systems are essential to the continued delivery of health care services. For example, heating, ventilating, and air conditioning equipment is used by hospitals to ensure that contaminated air is confined to a specified area such as an isolation room or patient ward. If computer systems used to maintain these systems were to fail, any resulting climate fluctuations could affect patient safety.

Despite their importance, VHA has not yet completed its assessment of facility systems. As of February 28, 1999, VHA medical facilities reported that they had assessed 55 percent of their facility systems. According to VHA's Director of Safety and Technical Programs, the remaining 45 percent have not been fully assessed primarily because (1) facility systems tend to be a combination of unique elements that have to be separately assessed for compliance -- a time-consuming process, and (2) VHA is still awaiting compliance status information from facility system manufacturers. VHA has not established milestones for completing its assessment and implementation of compliant facility systems. To help ensure that sufficient time remains to complete these activities, we recommend that VHA consider setting such deadlines.

On April 14, 1999, VA informed us that its February 28, 1999, report contained an error. The corrected numbers for facility systems at the end of February were 91 percent assessed and 9 percent not assessed.
I form a picture in my mind as follows:
  1. It is an immense job to penetrate down to the level of the 1,100 sites, provide necessary guidance and support and follow up to make sure the job is being done.
  2. Consequently, despite a very impressive picture at the top levels, the picture 3 levels down to the individual 1,100 sites may be abysmally bad.
  3. The top level effort won't even find out what the picture is at the working level until after August 1st. If they see a bad picture, top level administration will only have 4 months to respond.
  4. The Checklist is very good, if the sites were asking these questions 1 or 2 years ago. They are not suitable now.
VA Management appears to be several days late and several dollars short in their Y2K efforts at their 1,100 individual facilities.



-- regular (zzz@z.z), June 29, 1999

Answers

Font off?

-- regular (zzz@z.z), June 29, 1999.

I have known the author, the molecular biologist, for over twenty years.

If he says that that particular institution is clueless then his word is as good as gold.

He is going back in to that VA hospital again, early next week. We will hear more.

-- Paul Milne (fedinfo@halifax.com), June 29, 1999.


My experience with Y2k projects is that they generally put everyone's favorite scapegoat in charge (typically a female who is thrilled by her increased responsibility, convinced that at last she has broken the glass ceiling). They they put all the undesirables on the project, knowing that they will be able to get rid of them without fear of lawsuits once the work is complete. Everything works to the advantage of the man on top.

-- at work (dontmail@me.com), June 29, 1999.

VA hospitals have a pretty sorry record even in the best of times.

-- Tom Carey (tomcarey@mindspring.com), June 29, 1999.

If this is how our veterans are being thought of, think about how much *you* are...

-- BiGG (supersite@acronet.net), June 29, 1999.


BiGG,

You have to remember that the yellow stain in the WH actively avoided mil service, and hates the mil to this day, including all those who serve in it, and who have served.

Considering the way the vets have been "treated," second-class citizen status is high, indeed!

The fact remains that nobody cares about the vets, as evidenced by the almost total lack of response to an article that exposed yet another common, but ignored attitude towards the vets: medical experimentation subjects, aka lab rats. When I posted the URL to that article on vet forums and newsgroups, I got ZERO response.

Just in case you've nothing else to do, it's at:

http://abcnews.go.com/sections/us/DailyNews/veteransresearch990419.html

All vets deserve better than they've gotten, and I doubt that they'll ever get the recognition and rewards for their sacrifices that they've earned.

Not in a country and in a time where lies and dishonesty are rewarded.

-- LP (soldog@nohotmail.com), June 29, 1999.


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