Thanks to the COVID-19 pandemic, VA has seen a 321% increase in the average weekly telehealth video encounters between veterans and providers. Photo from Sept. 13, 2017, VAntage Point blog
WASHINGTON — As VA faces a post-pandemic landscape that includes an increased reliance on telehealth, it is looking to put its money where its healthcare needs are.
Last month, the agency published a $1 billion contract offer looking for one or more contractors that will not only procure the physical devices needed to gather remote health data from veterans but the infrastructure to make sure that data gets to VA providers.
VA’s Commodities and Services Acquisition Service (CSAS) and Denver Logistics Center (DLC), which manage the supply chain for VA’s telehealth and prosthetics programs, have been tasked with procuring Remote Patient Monitoring-Home Telehealth (RPM-HT) services that can meet the needs of veterans across the entire system.
On the patient side of the equation, the contract includes the procurement of peripheral devices designed to gather patient data: pedometers, spirometers, blood glucose monitors, coagulation monitors and others. The contractor will also be responsible for securing the data gathered by those peripherals, hosting it on a secure server, providing the system through which VA physicians can access the technology, and providing technical support for users on both ends.
“Once received, the vital sign data are stored on the server and then forwarded to VHA clinicians over the VA intranet,” VA explained in its contract request. “Software algorithms on the contractors’ servers prioritize patients according to the risk level of their condition based upon responses to the [disease management protocol] questions and the relationships of vital sign data thresholds.”
The two-year contract has six optional one-year re-up periods with a total maximum value of just over $1 billion that can be spread out across as many as four vendors.
VA has experienced a 321% increase in the average weekly telehealth video encounters between veterans and providers, Ryan Vega, MD, MSHA, the chief officer of the Office of Healthcare Innovation and Learning in the VHA Office of Discovery, Education and Affiliate Networks, wrote in a blog post last month.
VA also is looking at switching providers for its enterprise cloud computing services. Last month it issued a request for information (RFI) asking about the cost versus value balance ratio of either adding to or switching from its current cloud computing providers—Microsoft Azure and Amazon Web Services—when those contracts expire in FY 2022.
VA has begun to rely heavily on cloud computing in recent years, and VA leaders have touted the department’s ongoing move to the cloud as one of the reasons that veteran data will remain safe and intact as the department moves forward with the installation of its new electronic health record.
In an interview during the online conference FedTalks 2021, Acting VA Chief Information Officer Domnic Cussatt talked about VA’s reliance on the cloud, and how it’s unlikely that the department’s telehealth use will decrease once the immediate crisis of the pandemic is over.
“We were seeing reluctance among our patients and clinicians in using it fully because they preferred that face to face interaction. But the pandemic really forced our hand,” Cussatt explained. “One of the things that really helped us transform the way we deliver healthcare to a telehealth platform quickly was our move to the cloud, which we’d already executed. That helped us scale at speed. We were able to scale up the unanticipated needs of the pandemic with little prior planning because the platform and capabilities were already there. It will also allow us to scale back down, but we know that this will be a permanent state for us at VA.”
According to Cussatt, this move to the cloud effectively quintupled VA’s telehealth capability. Of the over 700 digital applications in VA’s inventory, 127 had already migrated to the cloud, and 76 were in process as of August 2021. Programs that have already migrated include Office 365, the applications that run VA’s legacy VISTA system, and VBA management services.
“We really knew that it was VA’s aim to transform the way we do our mission and these processes. Nobody can do anything in business anymore without a strong IT backbone and underpinning,” Cussatt declared.
While the recent RFI acknowledges that the current VA Enterprise Cloud (VAEC) system has served the agency well during a time of exponential growth, it is still seeking details on how much replacing Microsoft and Amazon as providers would cost, and what value the department might achieve if it did so.