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The VA's computer systems meltdown: What happened and why

Not following best practices can render the best technology useless

By Dian Schaffhauser
November 20, 2007 12:00 PM ET

Computerworld - At times, the bad news coming from the U.S. Department of Veterans Affairs seems unstoppable: D-grade medical facilities, ongoing security and privacy breaches, and a revolving door of departing leadership. In September, during a hearing by the House Committee on Veterans' Affairs, lawmakers learned about an unscheduled system failure that took down key applications in 17 VA medical facilities for a day.

Characterized by Dr. Ben Davoren, the director of clinical informatics for the San Francisco VA Medical Center, as "the most significant technological threat to patient safety the VA has ever had," the outage has moved some observers to call into question the VA's direction in consolidating its IT operations. Yet the shutdown grew from a simple change management procedure that wasn't properly followed.

The small, undocumented change ended up bringing down the primary patient applications at 17 VA medical centers in Northern California. As a result, the schedule to centralize IT operations across more than 150 medical facilities into four regional data processing centers has been pulled back while VA IT leaders establish what the right approach is for its regionalization efforts.

The Region 1 Field Operations breakdown of Aug. 31 exposed just how challenging effecting substantial change is in a complex organization the size of the VA Office of Information & Technology (OI&T). Begun in October 2005 and originally scheduled to be completed by October 2008, the "reforming" of the IT organization at the VA involved several substantial goals: the creation of major departments along functional areas such as enterprise development, quality and performance, and IT oversight and compliance; the reassignment of 6,000 technical professionals to a more centralized management; and the adoption of 36 management processes defined in the Information Technology Infrastructure Library (ITIL).

As part of the reform effort, the VA was to shift local control of IT infrastructure operations to regional data-processing centers. Historically, each of the 150 or so medical centers run by the VA had its own IT service, its own budget authority and its own staff, as well as independence with regard to how the IT infrastructure evolved. All of the decisions regarding IT were made between a local IT leadership official and the director of that particular medical center. While that made on-site IT staff responsive to local needs, it made standardization across sites nearly impossible in areas such as security, infrastructure administration and maintenance, and disaster recovery.

The operations of its 150 medical facilities would relocate to four regional data processing centers, two in the east and two in the west. The latter, Regions 1 and 2, are located in Sacramento, Calif., and Denver respectively, run as part of the Enterprise Operations & Infrastructure (OPS) office.

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