Kurt DelBene, VA Assistant Secretary for the Office of Information Technology and Chief Information Officer
WASHINGTON — VA’s new assistant secretary for the Office of Information Technology and Chief Information Officer is the 10th executive to serve in that post in as many years.
Kurt DelBene steps into the role at a time when VA is juggling several massive IT modernization projects, including a new scheduling system, a supply chain management program and the struggling electronic health records modernization (EHRM) project. He was confirmed by the Senate last month.
VA has developed a reputation for taking on IT projects that fail to live up to their potential, either through cost overruns, missed deadlines or products and systems that do not work properly. Watchdog organizations like the Government Accountability Office (GAO) and VA’s Inspector General have regularly pointed at the high turnover rate and lack of consistent vision at the CIO position as one of the clear reasons for these repeated failures.
DelBene spent the better part of the past 27 years as a senior executive at Microsoft. He left the company in December 2013 to spend seven months as an adviser to the secretary for Health and Human Services to address problems with that department’s healthcare.gov site after its initial failure. While there, he helped implement and execute the first open enrollment period before eventually returning to Microsoft in 2015.
At his confirmation hearing before the Senate Committee on Veterans’ Affairs last month, legislators were hopeful that DelBene’s extensive experience fostering major technology projects, both in the private and public sector, would allow him to hit the ground running at VA.
“If your office doesn’t work well, employees can’t do their job,” declared Committee Chair Sen. Jon Tester (D-Mont). “Veterans may not get their GI payments on time. An app for veterans to schedule their healthcare appointments just might not work. And while your office is not currently in charge of the CERNER EHR program at VA, that program can’t recover without a well-functioning OIT office.”
DelBene agreed, noting that VA’s ability to fulfill its basic missions of providing benefits and healthcare will depend on its ability to complete these IT projects.
“I believe there’s never been a time when IT excellence has been more important for the VA and for government overall. Information systems are at the heart of delivering critical services to our veterans, especially now, when modernization of critical systems is underway,” DelBene said.
Prioritizing Projects
Asked how he would prioritize which projects get the most funding and attention, DelBene said, “You need to jump in and understand all the needs across the organization, … and then you really need to stack-rank the priorities super clearly. There can only be one Priority 1 and one Priority 2. That’s a really challenging thing to do. You need to do that with stakeholders so that they agree that those are the priorities. Then you need to have the difficult discussion of how do you trade off different things that all seem to be high priority.”
At some point, he explained, there will need to be some IT needs that are deferred to a later date.
Asked what he learned assisting the healthcare.gov rollout, DelBene said the lesson he took away was the importance of having a development team that understood the big picture.
“The way they approached that problem was to define an architecture, then sub it out to different contracts and have them work largely autonomously of each other, and then bring it back together in the end,” he explained. “It probably wasn’t surprising that, when it came back together, it didn’t function. There was a bit of finger-pointing. It gets down to you need to have a team that works across these contractors as a single team.”
That experience also reinforced his belief in the importance of establishing priorities and making those clear to every stakeholder.
“When you get into an organization that isn’t functioning as well as [you want it to], everything is Priority 1,” he said. “Yet you can’t do everything as first priority at the same time. You have to strictly say, ‘These are the things we’re going to get accomplished in this order,’ and you have to have transparency with stakeholders and say, ‘This is the stuff we’re not going to get done right now. This is what we can get to you right now.’”
This attitude is something he expects to bring to major projects at VA, including the EHRM initiative, which DelBene expects to have a hand in despite recent restructuring at VA that takes that project out of the CIO’s direct purview.
A recently completed strategic review of the EHRM rollout caused VA to rethink the organizational structure of the project and create a program executive director for EHR integration position that reports directly to the deputy secretary. Last month, VA announced that it had chosen Terry Adirim, MD, MPH, MBA, to fill that role. Adirim is the principal deputy assistant secretary of defense and is currently serving as the acting assistant secretary of defense for health affairs.
