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EHR failure partly to blame for VA troubles

Kenneth Corbin | July 24, 2014
In a wide-ranging critique of the U.S.' federal IT, former defense secretary Robert Gates says the inability to set up an electronic health record system linking the Pentagon and the VA is one of his 'chief regrets.'

But the costs of those and virtually every other large-scale tech transformation CIOs are weighing are front-loaded, which can make them difficult to implement in a time of rigid budget austerity.

"The challenge here as with many areas of government reform is that IT initiatives that can generate major savings over time typically require a significant financial investment up front, all the more difficult in an era of sequestration," Gates says.

As a practical matter, then, that budget reality argues against going for the big score -- say, a wholesale migration of an agency's systems and infrastructure to the cloud. Government tech watchers have often warned against the "big bang approach" to federal IT projects, calling instead for a more incremental, measured process of scoping, acquiring and deploying systems. Some observers have suggested that the botched roll-out of the Healthcare.gov website was doomed from the outset by virtue of the ambitious scale of the project.

Beyond setting reasonable expectations for tech deployments, Gates echoes a familiar lament among advocates of government IT reform when he calls for greater cooperation and harmonization both within and among agencies.

DoD Takes IT Into Its Own Hands
At the Pentagon, Gates set in motion a concerted push to streamline the Defense Department's IT operations, a process that began with an assessment of the systems and facilities in place.

"We found that most of our bases and headquarters had their own separate IT infrastructure and processes, which drove up costs and created cyber vulnerabilities," he says.

Though DoD maintains what is far and away the largest IT operation in the federal government, the fractured situation that Gates describes is hardly unique. All across the government, stories abound about bureaus and sub-agencies running their own IT shops, often headed by a more or less autonomous CIO and run with minimal coordination with other units of the organization.

By operating in those types of siloes, agencies have somewhat predictably ended up with underused data centers and duplicative commodity applications like email.

"Government agencies will have to collaborate more instead of approaching technology in a stove-piped and fragmented way," Gates says. "Turf fights, parochialism and the demand of each organization exclusively to own its own IT all must give way to new thinking and new approaches, and that will take sustained leadership and management discipline."

"What is needed most of all are leaders who are prepared to challenge convention thinking, break crockery, stop doing what doesn't work well -- or at all -- and set a new course, all of which of course is the opposite of what goes on in most bureaucratic structures. But radical departures can be done," Gates says.

 

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