Veterans Affairs Requirements Development

Customer: Department of Veterans Affairs, Veterans Health Administration, Enterprise System Managers

Challenge: Create a requirements development and management strategy for the Veterans Health Administration (VHA) that addresses clinic/medical center customer needs as well as VHA strategic goals.  In the late 1980’s and early 1990’s the VHA fashioned a world-class, cutting edge IT system for handling patient clinical and non mission critical IT requirements.  By 2005, the aging network was in need of an upgrade in the form of improved process, policy, and procedures to ensure Veterans and VHA health care providers continued to receive fast, effective, and reliable access to information.  By 2009, the Secretary of Veterans’ Affairs initiated new operational plans (OPLANS), improved program management philosophies (PMAS), and rededicated themselves to the development of electronic health records for all Veterans (VLER).  In this resource constrained environment, the Secretary’s commitment to improved Veteran health care and DOD-VA data exchange made it imperative VHA develop a verifiable, accountable, and traceable requirements development process. 

Approach: WBB developed a two-prong approach to addressing the VHA’s needs: 1) WBB used working groups comprised of business owner clinicians, doctors, nurses, administrators, and other VHA stakeholders to identify benefit and risk criteria mapped to strategic goals.  2) WBB developed a requirements development process to move initiatives from initial idea to final development in a rational and systematic fashion.  Using collaborative sessions, decision analysis tools, and beta testing of the process, WBB coordinated the development of initiative process flows, criteria filters, feedback loops, and data repositories.  WBB worked with the VHA to develop routine, patient safety, fast track, and mission critical process flows designed to provide transparency and stability to a vigorous and dynamic $450M a year IT process.  Building upon business owner inputs, WBB worked with the VHA Enterprise System Managers (ESM) to refine internal procedures, document required governance enhancements, and provide VHA leadership with proposed priority initiatives and optimized courses of action.  WBB placed their own senior, experienced consultants into various health care products, data systems, management and financial services, and registration and eligibility requirements development positions to leverage and fully understand VHA requirements management procedures.  Using collaboratively developed weighted criteria, WBB oversaw development of prioritized lists of initiatives addressing critical and non-critical patient care IT gaps, shortfalls, and fixes.  As a result, the VHA Office of Health Information (OHI) was able to submit clearly articulated, integrated, weighted, prioritized, and evaluated initiatives for annual resourcing decisions. 

Value: WBB assisted the VHA in creation of a verifiable, defendable, and repeatable process for evaluating IT proposals against business owner needs and organizational strategies.  WBB combined state of the art decision analysis methodologies and support tools, sound requirements development principals, and old-fashioned common sense, into a comprehensive policy, procedure, and process review for the VHA.  The WBB facilitated collaborative sessions created stakeholder buy-in that allowed for major process changes with minimal resistance.  WBB’s tailored approach was developed specially for the VHA taking into account their extensive expertise, organizational goals, and unique culture.  As a result, the VHA was able to clarify its IT requirements and simplify resource decisions.  WBB’s approach allowed VHA to sustain delivery of world-class medical care for Veterans while simultaneously moving their organization into the next stage of improvement development.