Electronic Health Record Modernization: VA Needs to Address Change Management Challenges, User Satisfaction, and System Issues
Abstract: VA uses the Veterans Health Information Systems and Technology Architecture (VistA), which includes the department's legacy EHR system, to provide health care to its patients. In June 2017, VA initiated the EHRM program to replace VistA because it is technically complex, costly to maintain, and does not fully support the need to exchange health data with other organizations. Specifically, VA began to acquire the same EHR system DOD was acquiring. VA has reported obligating about $9.42 billion on EHRM from fiscal year 2018 through the first quarter of fiscal year 2023. GAO was asked to testify on its recently completed review to determine the extent to which VA has (1) used organizational change management strategies for the EHRM program consistent with leading practices, (2) assessed satisfaction with the new system, and (3) identified and addressed EHR system issues. GAO identified leading change management practices and evaluated VA's activities against these practices.
Abstract: This research set out to investigate the experiences of ‘grown up’ children from armed forces families, to gather their reflections on childhood and education, and to seek their advice to inform the current armed forces community, policy-makers and practitioners. The Service Children’s Progression Alliance (SCiP) defines a child from an armed forces family as “a person whose parent or carer serves in the Regular Armed Forces, or as a Reservist, or has done at any point during the first 25 years of that person’s life” (SCiP, 2017: para 2) and the Office for Students refers to this definition in their documentation relating to student characteristics (OfS n.d. para 8, see also OfS, 2020: para 11). In this research we use the term ‘grown up’ to indicate individuals over the age of 18 recognised to have reached the legal age of adulthood in the UK. This group of individuals are currently overlooked in research, policy and practice as the focus continues to be on serving members of the armed forces, veterans, and families, including school-aged children.