The untold story of VA Leadership
Last week I was honored to host VA Deputy Secretary Sloan Gibson to the Harvard Kennedy School, on behalf of the Institute of Politics.
West Point, Army Ranger, and Harvard Kennedy School trained, Gibson is essentially the Chief Operating Officer of the VA. He’s responsible for an organization with an $177 billion budget, 370,000 employees, and a board of directors that include 535 Congressional members, as he reminded the students. The VA is also the country’s largest integrated health system, with 1,700 points of care serving approximately 9 million Veterans who are enrolled for VA healthcare.
The scale and scope of the VA — equivalent to the size of a fortune 10 enterprise — provides unique opportunities, Gibson noted. It enables the VA to offer the high quality, integrated care to veterans in need (including caregiver support, homeless services, disability compensation, education benefits, burial benefits, and much more). It also allows VA to identify clinical and administrative best practices in the field, disseminate these best practices to other sites across the system, and encourage standardization of practices that improve outcomes for Veterans.
But as Harvard College senior Jane Labanowski mentioned in her personal introduction of the Deputy Secretary, Gibson cares deeply about individual veterans, and connects with them.
Labanowski had the opportunity to meet Gibson last spring through my Harvard Kennedy School field class, where she and teammates worked closely with the VA to re-imagine how to better serve Veterans going through the benefits appeal process.
Deputy Secretary Gibson joined the VA in 2014, and one month into the job, was asked by the White House to co-head a committee for Smarter IT across the federal government.
Gibson has an impressive business background, as does Secretary Bob McDonald (who was the CEO of Procter and Gamble previously), but Gibson was admittedly not an expert in IT. “It’s all I can do to spell IT,” Gibson joked.
But Gibson recognized the importance of smart, focused teams — and sponsored the first agency team of the U.S. Digital Service, which previously was only a White House effort. Led by VA CTO Marina Martin, and later joined by Giuseppe Morgana (HBS 2015), the VA Digital Service (35+ FTE and 55 contractors) is leading the effort to unify and improve the experience veterans have online, such as applying for healthcare or benefits, onto a single website that is being built iteratively, vets.gov.
Throughout 2017, the VA will collapse over 500 veteran-facing sites into a unified veteran experience. By fixing things as simple as browser compatibility, the VA Digital Service has already increased online healthcare application submissions from 62 per day to 500 a day.
On December 6th, vets.gov launched a single login, a better prescription drug refill function, secure messaging with doctors, and much improved online claims status function. And in early 2017, Veterans will be able to schedule primary-care appointments through an app on their phones, tablets, or computers.
This isn’t about tech for its own sake — these improvements are designed to help real Veterans, like Dominic, a 35 year old Veteran who has been in and out of homelessness with his daughter over the past couple of years. Below is a video of Dominic trying to apply for benefits the old way, and at bottom, a video of Dominic applying using a Vets.gov prototype.
The VA Digital Service and their work on vets.gov is part of a larger initiative to make the VA Veteran-centric, rather than VA-centric. This effort, dubbed “MyVA” has been demonstrating strong progress in 2016, including:
- Improving Veteran Trust. A year ago, only 47% of Veterans said they trust the VA to fulfill their country’s commitment to veterans; that number is now 60%. That metric is still way too low, but is measurable progress.
- Improving Access to and Quality of healthcare. At 116 (of 166) Medical Centers, the VA now has the processes and systems in place to provide same-day services for those Veterans that need it, in primary care. In FY 2016, VA completed nearly 58 million appointments, which represents 1.2 million more than in FY 2015 and 3.2 million more than FY 2014.
- Answering the Phone. Remarkably, in January 2016, 59% of phone calls to the VBA national call center were being blocked because of call volume and long wait times to get served. The blockage rate is now less than 1% and average speed to answer is down to less than 1.5 minutes — with an ultimate goal of less than 30 seconds.
- Transforming Culture. Deputy Secretary Gibson related the story of Donald Siefken, an Army veteran who drove four hours to the nearest VA facility to get treatment of a broken foot. But when he called for help from the parking lot, the VA employee told him to call 911 to get an ambulance. Gibson has a simple rule: what if that Veteran was your mother? What would you do then?
Gibson, who is also the protagonist in a recently published HBS Case on the VA, told students that his job primarily consists of management and leadership, not policy-making. In fact, he finds himself dealing with policy mostly when it is an impediment to transforming and modernizing the VA, he noted.
The Deputy Secretary also reminded students that public sector management is too often focused on the wrong thing; remarking that “government likes to focus on inputs and activity, rather than outcomes and impact.”
The VA traditionally hasn’t partnered well, but under Gibson’s leadership, enhancing strategic partnerships is now one of the five critical strategies underpinning the broader MyVA transformation. Massachusetts Secretary of Veterans’ Services Fransisco Ureña was in attendance, who, along with other members of the National Association of State Directors of Veterans Affairs, has been a critical partner in helping to design and advocate for some of the Department’s breakthrough priorities.
It’s clear that the VA has made some impressive progress, especially in the past couple years — yet the Presidential election seemed to focus on shortcomings of the VA when Veteran issues were discussed. I asked Gibson about this dissonance, and he acknowledged that recent reforms and progress aren’t yet well known.
Gibson told the students he is totally fine with anyone, including the incoming Administration, getting credit for these improvements, as the end result is what really matters: Veterans getting the care and help they deserve.
