Digital VA Expo

Date:

DENIS MCDONOUGH

Good morning, thanks for that warm welcome; and, Jean Gurga, thanks for the kind introduction. Let me start by saying how much I regret not being with you in person. Despite all the technological advances we are about to discuss, we don’t have a way around a heat wave and Canadian wildfires completely upending commercial aviation in the U.S.

I want to start with a story about a homeless Veteran, living in a tent in the parking lot of a Delaware shopping mall during the cold of winter. When the police arrived to clear the encampment, they noticed that the man’s tent was made of old Army fatigues. So before the police did anything, they gave a call to their local VA partners, and a VA employee talked to the Vet.

For years, the Vet assumed that he was ineligible for VA care. So he had never signed up, and didn’t have the documents with him that he needed to enroll. Within minutes, the police pulled up the Vet’s profile on SQUARES—an app that provides VA employees and our trusted community partners, like local police departments, a reliable, detailed report on Vets’ demographic information, health profile, and VA eligibility. In short order, they learned that the Vet was eligible for critical services, including housing assistance.

That information changed everything. The Vet’s demeanor softened as it dawned on him that the police and VA were there to help him, a fact that was made clear by that simple tool. It helped build trust; trust that enabled a Vet to give VA a chance, trust that allowed VA to connect one more Vet with transitional housing and eventually a safe, permanent home. And that’s what can happen when Veteran-centric programs are coupled with new innovations.

The right technology can do a lot of good for Vets. It’s having a real impact, right now, in the lives of Vets across America. What strikes me is not just the promise of new apps, new IT infrastructure, or new digital products, but rather the huge opportunity to tackle the most complex challenges by tirelessly pairing new technology with our age-old comparative advantage at VA: an unrelenting focus on Veteran-centric programs.

So, I’m going to spend a few minutes talking about where we were at VA, where we are, and where we are going. And while I want you to hear that technology is a key enabler of the story I tell, the protagonist in our ability to deliver on the promise of new technology is you.

The Veteran experience in the past was marked by a lack of accessibility, little integration, and few digital health care options. On accessibility, for example, Vets had to fill prescriptions by traveling to VA facilities. Or to appeal a claim, they had to travel to regional offices and appeal boards, sometimes far from their homes and their communities. Meanwhile, Veteran information was stored in multiple locations and across disparate applications. The simplest of tasks, like updating personal information, required visits to multiple outdated websites. There was little access to tele-health care—especially for underserved populations and those in rural locations where there is no internet access, no 5G networks.

Suddenly, we found ourselves in the midst of a once-in-a-century global pandemic. Think for a minute about the fears you had at that time. I remember many–too many to confess to you today–and those fears were real. And notwithstanding those very real fears we each felt, a group of professionals at VA—from the moment the pandemic hit—mobilized around one core mission: saving and improving the lives of Veterans, their families, caregivers, and survivors during this time of need. We know now that they–that so many of you–succeeded in that effort. But you did not know then that you would succeed. None of this was foretold. All we knew is we had you.

And you jump-started innovation and changed the way we do business. VA had long been the largest provider of telehealth services in the country, but we dramatically expanded telehealth use across clinical services. Vets needed the ability to appeal benefits decisions online, and to receive benefits decisions quickly. Vets, families, and survivors needed ways to virtually memorialize and remember lost loved ones when they couldn’t visit their final resting place in-person. And as more of our work became web-based, digital tools became even more important.  

So you reached out to Vets, and listened to what they wanted from their digital experience. And using a human-centered design approach—a Veteran-centric design approach—you developed tools to ensure Veterans and their caregivers have positive, productive online experiences when engaging with VA. You retooled VA.gov to make it the “digital front door” for all the services VA offers Vets, whether that is to make a medical appointment, to file a claim, and to apply for education benefits. And the new VA Health and Benefits Mobile App is replicating that, giving Vets access to all VA services—right in the palms of their hands, wherever they are. This is one app—replacing a collection of websites and apps that required Vets to wade through a spaghetti junction of entry points to get to us—now with one door, on their phone, that gets us to fit our services into Veterans’ lives. So while a Vet’s picking their kids up from school, they can use this app to refill a prescription, send a secure message to their doctor, change an appointment, and receive a notification when their doctor replies.

Each month, nearly 700,000 active users on the app send a quarter-million secure messages and book or change 645,000 medical appointments. The VA app is one-of-a-kind in the federal government, with nearly 2 million downloads and tens of thousands of users giving it an average rating of 4.8 out of 5 stars. That customer rating puts the VA app on par with those from companies such as Bank of America, USAA, and United Airlines—showing we’re making good progress towards our goal of meeting Vets’ expectations and fitting our services into their lives, not requiring Vets to change their lives to fit into our services.

The results speak for themselves. Since President Biden took office, VA has provided more care and more benefits to more Vets than ever before. And throughout, Vets’ trust in VA has grown stronger. Here’s the point: we at VA are about shaping Vet solutions that meet them where they are, that are adapted to them and their needs, rather than expecting Vets to adapt to us.

So, what’s next? As we look to the future, one that, God willing, will be pandemic-free, we will not try to build a VA that goes back to some old normal. We will, we must, continue to do better for Vets by building on the innovation that you led over these last three years. The fact is that we do not have a choice because we have a real opportunity to expand the number of Veterans we serve. The PACT Act—the toxic exposure law signed by President Biden last August—is going to help us deliver care and benefits to millions of toxic-exposed Vets and their survivors, bring generations of new Vets into VA health care, and increase the benefits of many more.

If we do this right, we can make the PACT Act the largest expansion of VA care and benefits in this agency’s history. That historic growth will require us to speed up claims processing, to provide more timely accessible care, and enhance the experience for Vets we’re already serving, as we welcome those we’ve never served before, and those who are giving VA a second chance to get it right for them.

This means we need to do IT right, and we need to do it at scale. We have to reduce downtime and avoid IT outages that slow our responsiveness. We have to continuously protect Vets’ information and rapidly respond to emerging security threats before Vets are put at risk. And we have to treat VA data like the strategic asset that it is—unparalleled data which includes over 10 billion medical images and the largest genomic research database linked to anonymized health records in the world. We must serve Vets with data-driven decisions that makes Veterans’ lives better.

So we’re partnered with industry to leverage best practices in AI, natural language processing, machine learning, and robotic-process automation technology. That means using automation to help us make better, faster, and more informed decisions, improving Veteran health outcomes and benefits decisions while eliminating redundant administrative tasks and workflows and promoting jointness across VA and with our federal and community partners.

We’re poised, right now, to deliver a completely new, fully integrated experience in which the support Vets need is just a few clicks away, right there in their hands. VA’s Digital Experience not only can be—but very well has to be—the most innovative, reliable, and customer-focused experience; not just in government, or the American private sector, but in the world.

And most importantly, as I said at the beginning, we have to draw on our fundamental comparative advantage. We need to always make sure that Vets are at the heart of everything we do; we must always be Veterans’ most zealous advocates. We’re still early in this journey. But we’re excited by the prospects and possibilities these emerging technologies provide to serve more Veterans, more efficiently, effectively, equitably, and accurately. And at VA, that’s what Veteran-centric solutions and innovation are all about—saving and improving lives.

In closing, I want to reflect on something President Biden often says about serving Vets:

He says: “Our country’s most sacred obligation is to prepare and equip the troops we send into harm’s way, and to care for them and their families when they return home.” The second part of that sacred obligation is ours to fulfill at VA. And it comes back to the promise our country makes whenever someone signs up to serve in the military. It’s a promise that’s as simple as it is fundamental. If you serve us, we’ll serve you when you come home. If you take care of us, we’ll take care of you. If you fight for us, we’ll fight for you. Keeping that promise to Vets has never been more important.

The tools we’re building at VA are a critical part of our ability to keep that promise. Technology won’t do it alone.  And we have seen many examples in recent years of the perils of overreliance on technology and automation—engrained bias, a proliferation of misinformation, and diminishing privacy rights. But here’s the bottom line. All the technology in the world won’t keep that promise without VA employees who keep Vets at the heart of their care. The VA team is the best workforce in the federal government; the most passionate, highest-performing public servants in the country, folks who want to make a real difference in the lives of Veterans. I’m blessed to call them my colleagues. And if you’re seeking a career of real purpose, I hope you’ll consider joining this great team.

VA’s vision for transforming the Veterans’ digital experience is urgent, and it is personal for all of us. But don’t just take it from me. Take it from some of the Vets we have the honor of serving. Roll the video.

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