Agency: New Management Program Being Implemented
A VA medical staffer walks out of a supply closet. VA has had critical problems with medical supplies during the COVID-19 pandemic and is in the process of implementing a comprehensive management program. Photo from Dec. 1, 2020, VAntage Point blog.
WASHINGTON — The COVID-19 pandemic has underscored VA’s lack of a comprehensive supply chain management program, and agency officials once again defended their progress before Congress.
This time, at a hearing occurring last month, both VA officials and agency watchdogs were much blunter in their assessment of the current situation and the challenges the healthcare system faces in solving the problem in the near future.
The shortage of personal protective equipment (PPE) in the early months of the pandemic turned VA’s supply chain issues into a more critical issue than it had been previously, revealing to the country that the nation’s largest healthcare system does not have a way to track its medical supplies from purchase to patient. Instead, in order to track PPE use nationally, an ad hoc reporting system was created with facilities manually inputting supplies and usage.
VA’s Office of the Inspector General (OIG) has already issued several reports this year documenting situations where medical facilities ran low on supplies and had to ration them.
“VA employees working in its medical facilities have reported to the OIG time and again that problems with aspects of supply chain operations, like procurement and inventory management, affect their ability to provide veterans with timely and quality health care,” VA Inspector General Michael Missal told the House VA Subcommittee on Oversight. “VA has also faced numerous challenges with using and developing the information technology systems that support these critical functions. The pandemic has stressed those foundations in ways one could not have anticipated even a year ago.”
Missal added, “Limited supplies affect not only patient care but also the protection of VA personnel working on the front lines. Although VA has significant experience and success in handling regional disasters, the global pandemic has changed how VA competes with all public and private healthcare systems for scarce but critical supplies.”
VA is currently in the process of adopting the DoD’s Defense Medical Logistics Standard Support (DMLSS) system, which would allow the department to track supplies across the entire system. That would provide transparency to the supply chain and give VA leaders an understanding of what facilities require what supplies. The system was piloted at Chicago’s James A. Lovell Federal Health Care Center—a facility that VA operates with the Navy—in August.
“This is the first year we had the program and, if COVID had not occurred, we would have moved faster than we have,” explained Deborah Kramer, VA Assistant Secretary for Logistics and Support. “Barring further slowdowns based on COVID disease rates we should be able to begin deploying additional sites later this year.”
Complete transition to DMLSS is expected by 2025. DoD is currently in the process of upgrading DMLSS to LogiCole—the next iteration of the system, however. The new system is expected to be ready next year.
Asked why VA is installing DMLSS when they will be forced to upgrade to LogiCole in the middle of the process, Kramer explained that VA cannot afford to delay another year.
“The big thing that changes between DMLSS and LogiCole is that the supply chain management system moves into the cloud,” Kramer explained. “For the user, much of it will be seamless. They’ll still click an icon on their desktop, but it will take them to a cloud version instead of a desktop version. It really does make sense. Frankly, we can’t delay. We need DMLSS. We don’t have a supply chain management system in VA. We have an inventory management system that can’t even take an expiration date. There’s no field for an expiration date in that system. The longer we delay, the longer it will take.”
Kramer expressed confidence that VA would be able to install DMLSS on schedule. Agency overseers did not echo that confidence, however.
“These challenges that VA faces with regard to its supply chain span all of VA,” explained Shelby Oakley, the Government Accountability Office (GAO) director of contracting and national security acquisitions. “There are many different stakeholders, many different equities, speaking different kinds of languages. You have people working on systems. You have logisticians. You have medical professionals. Being able to get all those stakeholders together to develop and buy into a strategy—to move that supply chain management system forward—is going to be a monumental task.”
Missal pointed out that complex projects like the installation of DMLSS are adversely impacted by inconsistent leadership, from which VA has suffered in numerous departments.
“One of the things we need to focus on is continuity. You have different systems being put in place, and it all comes down to a governance structure [and VA has had] five leaders in the past three years of the program that oversees that,” he declared. “What we’ve found in our reports is that they just don’t plan like they should.”
The second phase of the DMLSS rollout is slated for the Spokane and Puget Sound, both VAMCs, both in Washington, for FY 2021.
