Patchwork Approach

The lack of this kind of enterprise-wide view of supplies has been sorely felt during the pandemic. In March, VA officials implemented a patchwork approach relying on daily manual reporting from facility employees on COVID-related equipment levels.

Full rollout of the DMLSS system is scheduled over a seven-year timeline to loosely coincide with VA’s deployment of its new electronic health record system. Stone said this timeline was no longer acceptable but did not give specifics on how much that timeline could be shortened.

Citing VA’s poor track record when it comes to large IT projects, legislators asked what assurance they had that DMLSS would be successful when it was finally launched. 

“DMLSS is already in the field in DoD,” explained Deb Kramer, acting assistant undersecretary for Health for Support Services. “We’re not developing a one-off. We’re not developing our own system. We’re using a proven system.”

Scheduled to arrive sooner is VA’s updated version of its Medical/Surgical Prime Vendor-Next Generation (MSPV-NG) procurement system—the department’s primary means for purchasing medical supplies.

The Government Accountability Office (GAO) has submitted multiple reports noting that the current system has significant gaps, including lacking an effective medical supply procurement strategy, lack of clinician involvement in purchasing decisions and an absence of reliable data systems.

VA is working on a new version of the system, MSPV 2.0. Comments from GAO about the new system have been mixed, noting that, while it addresses some of the issues with the current system, it might leave others in place. A full GAO report on the MSPV 2.0 project is expected this fall.

The system itself has experienced significant delays in the contracting process, pushing the expected implementation date from March 2020 to February 2021.

VA officials stressed that, even if all of their supply management problems were solved, they will still face the same challenge being faced by every healthcare system in the U.S.—national manufacturing levels that are currently not able to meet the demand of COVID-related supplies.

At the height of the pandemic, VA was consuming 250,000 masks a day. American manufacturers were unable to keep up with the demand from VA and other healthcare systems, requiring those systems to buy from global manufacturers. This added to delays in addition to straining the global manufacturing capacity as facilities worldwide placed orders.

“There is still an enormous demand on PPE, not just in the United States but worldwide,” Kramer declared. “Manufacturing has not caught up with demand. We’re working hard every day to pull material in and sustain operations. We need more 3M production. We need more production from every N95 mask producer. We need U.S.-based gown manufacturing capacity here that can support readiness.”

According to Michael McDonald, director of government operations at 3M Health Care, the company has been ramping up production since January. In January, N95 production was at 22 million per month and had risen to 35 million by June. According to McDonald, 3M projects to be manufacturing 95 million N95 masks per month by October.