Cultural change at the VA has to go beyond the necessary initial focus on ethics and values. It needs to penetrate the bureaucracy. By Alex Nicholson
The Department of Veterans Affairs has become the nation’s second largest bureaucracy, and with that massive growth has come an even more massive over-complication of systems and processes within the organization. As the VA undergoes a transformative cultural change to help it make up for and prevent recurrences of the scandals that have rocked the veterans community this year, the department desperately needs to pursue another type of transformation too – simplification.
If I want to call a cab in most cities around the country, I no longer have to dial a telephone number and have a dispatcher radio drivers to arrange a pick-up. Instead, I take out my smart phone and a neatly designed and user-friendly app called Uber tells me my wait time, dispatches a car, tracks its progress, automates payment, and allows me to give instant feedback on service quality.
Similarly, if I need to schedule an appointment with a doctor, all I need to do is pull out my smart phone again or go to a website, and ZocDoc will give me real-time appointment availability for my local area. This benefits not only me, by allowing me to self-schedule a medical appointment on short notice with a provider within my insurer’s network, but it benefits health care providers too by allowing them to make more efficient use of their staff time and resources. And if I don’t want to self-schedule via the app or website, I can still call in my appointment request and get excellent customer service the old-fashioned way.
These are two examples of simple but scalable solutions to age-old problems that have very quickly transformed the way American society operates. They have brought a breath of fresh air to two arcane processes – calling a cab and scheduling a medical appointment – that used to be notoriously cumbersome and annoying. They have simplified life for users of these services, and they have simplified operations, reduced costs, and amplified revenues and efficiency for the service providers.
The VA needs to think - and more importantly be - more like Uber, ZocDoc and a whole host of other agile new enterprises that have managed to problem-solve on a massive scale by not over-thinking things. Rather than turning off potential problem-solving partners with mind-boggling and overly complex Requests for Proposals, the VA should always look first for simpler solutions that can more easily plug into its existing systems and which are already proven to work properly at scale.
(Related: VA Announces Major Reforms)
Too often the VA has spent tens and even hundreds of millions of dollars on custom technology and process solutions that simply reinvent the wheel, don’t integrate well with where and how veterans live their lives, and can’t keep pace with change. And even in the midst of what is supposed to be the dawning of a new open-minded era at the VA, we still unfortunately see a continuation of these same old ways of thinking about technology and process.
Reorganizing, reshaping, and reinventing the VA is no easy task, but the new secretary, Bob McDonald, has committed to pursuing transformation and innovation more aggressively than any of his predecessors. His private sector business background and the overtures he has made to fundamental change during his short tenure thus far are promising signs.
But cultural change has got to go beyond the necessary initial focus on ethics and values. It needs to penetrate the bureaucracy and the old-fashioned government operations mindset that inhibits innovation and progress at the VA.