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tv   VA Secretary Dr. Shulkin Discusses Health Care Innovations  CSPAN  August 12, 2017 7:21am-7:44am EDT

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the victim police department pay that much attention to it, and now the sense is that the police are overwhelmingly in african-american communities, but not to protect those communities. but wrath are rather to lock folks up. on q and a. next veterans affairs secretary david talks about innovation in the v.a. health care system, and event where dozens of innovator and technologists talk about ways to deal with the v.a.'s problems. [applause] good morning everybody. >> good morning. i like the energy in the room. >> and really great to see everybody here. how many people work in v.a. is this wow. that's great.
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wow i'm really glad that all of you could be here today this is important and i really want to thank you for your engagement voment in what you're doing to -- make v.a. a better place as you know, v.a. has a great tradition of -- developing and disseminating innovation all of you so many of the things that we rely upon every day and families rely upon kale out of the v.a. system. so you are following in the footsteps of lots of great anyone vai tores in v.a., and one of the things that i don't think people realize, though, coming upon you to let your colleagues around the country know is that with all of the -- responsibilities now that come with -- so many people who work in jobs to increase productivity and to -- , you know, have their use in health care and everything else,
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that v.a. is actually probably one of the best places to be able to have time and able to innovate so we have to promote and let people understand that this is really a great place to be doing the types of things that all of you are able to do and colleagues and other physicians who work in private sector don't sometimes have the ability to spent the time and energy on innovation is is like we have the ability at the v.a. and so with that is a responsibility to take what you're doing and make sure that is gets spread throughout the country that people know about it. that's really what today is about. so wonings again just thank you for being here. thank you for continuing the work that you're doing, and this is really important for us to do. some of you may know particularly those who were here
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last year how many were at last year's document mow day? okay only a few. so for many of you this is new. people then may not know that -- my favorite tv show is shark tank. [laughter] and -- i just love the energy and spirit of the entrepreneurs who present to the sharks and honesty that sharks have, and for those of you who do or who have seen shark tank, you know that those entrepreneurs that don't get any bids that don't get one of the sharks to invest the most common reason is because the entrepreneurs have developed a company or developed an idea or product that really doesn't so solve a problem. and you can innovate and really not get traction with your
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innovation if it's not solving a problem. and so one of the things that i would really look to see us do in our innovation network for all of you who are working on things is to make sure that you're solving one of the problems that our veterans are experiencing one of the problems that we as v.a. are experiencing. and so the question i ghost commonly as secretary and probably wuflt questions that -- you're asking with v.a. with problems that we have with issues that people continue to talk about that v.a. suffers from is v.a. fixable? can we actually fix this system? and if so how do we fix it? and my answer is i firmly believe that we can fix this system. and the way that we can fix this system is through transparency.
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and being open and honest with problems that we have because only way that i know how to pick something is to acknowledge that you have a problem, talk about the problem, so that you can find creative ways or to innovate what the solutions to the problems are. so the first thing that i did in a very public way when i became secretary is i went out and i thought, well, let's make sure that we are transparent about our problem pep and i identified 13 areas of big risk for v.a. i believe if question don't solve these 13 risk areas that we will not transform this organization. we will not create a sustainable organization that we can feel proud of that accomplishes our mission. and when i did that i decided look if you're going to do a strategy go big. so i --
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asked the president whether i could announce those 13 risk areas from the qhows briefing room. never been done before by cabinet secretary. and i on live tv went out and gave our risk areas. did any of you sew that e by the way. few of you did. now, so what i would say to you as innovators what we need to be doing is we need to be innovating and solving the problems our organization. i can't remember 13 areas off the top of my head. but -- [laughter] by let me just read them to use and -- then then come around to that. so access to care and hanging our providers. community care in general, how we send people out into the community. the quality of care and v.a.
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disability claims in appeals. information technology problems, capital, staffing, bureaucracy, broad by and bows and veteran setses. suicide. so what you've been seeing us do at v.a. is actually ticking through the 13 risk areas and beginning to address them. so if in information technology, you'll notice that we're creating strategy to move towards a commercial off the shelf technology solution, same one that department of defense uses under under facilities and capital assets we're announcing that we're going to be disposing of 1100 facilities that are either vacant or underutilized under accountability we passed a
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new accountability and whistle-blower protection act so you'll see the solutions that we're announcing are beginning to address these 13 risk areas, and i would hope that work that comes out of today will help us with that too. now, because 13 areas are too much for me to remember. and i have to pull out a sheet of paper, i've actually developed five strategies for v.a. to move forward because i can with remember 5 but not 13. and so let me just review those so as use begin to start thinking about your innovations and the work that you'll continue to do over -- over the next year. the more that you can target your innovation to one of the five strategy the more that their likely to stick the the more that -- we as sharks here in washington -- washington, d.c. e likely to support your innovation and disseminate it. so first of those strategies
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involves choice. and that is, is that the fundamental way that we will fix our system is to give veterans more choice. to make them consumers that we have to have a product that they want. that they are going to want to choose v.a. as a way to help them improve their lives. and that means that as tough as it is we're going to have to open up our system to be more competitive with private sector when veterans choose health care they're going to choose between a v.a. facility or choosing to go into the private sector. that will fundamentally raise our level of performance. that will make us be more responsive. that means the more that we can give veterans information about quality of care, about the service that we provide, the more that we can improve our
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service, the more that they'll want to choose us. and this is a overall strategy that fundamentally will put us on the sustainable course to a viable competitive system for years to come. so anything that we can innovate that puts the veteran in control of their decision making that allow them choice, is going to be key to one of our strategies. now, the way which we're doing that legislatively or working to change the roles of the choice program to eliminate the 40 mile, 30 day requirement which is administrative role to put the -- patients, veterans back in the decision making role about when had it makes sense to use v.a. when it makes sense to get care in the community so that's the first strategy. the second strategy is to -- improve the timeliness of our services. and this is our issue of wait times.
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for veterans -- the crisis that v. averment entered in 2014 starting in phoenix. question still struggle with access to care and wait times. one of the ways that we innovated on this was we now publish our wit time so ohmly transparent for everybody to see on websites exactly where our wait time are for any type of appointment that they want to get. we update that now weekly. we're the only health care system in the country that publishes wait too many. there's no other and this is a way that v.a. is innovating in transparency and we'll continue to add we're adding quality of care information. we're adding satisfaction information. we'red aing nursing home quality information. so this is a primary strategy on timeliness to access. terms of timeliness of disability claims we currently have 89,000 disability claims that people wait more than 125
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days for a decision. in september, we're going to be announcing a new process of the decision ready clam where veteran will be able to get a decision within 30 days not waiting days and waiting on technology to do instant matching just like you can get an instant decision on the credit card or credit score on your pone. moving toward disability claims where we'll be able to do instangt instant decision on that so lots of innovation we can do around timeliness of our services. in appeal, in appeals you have to wait six years right now if you're to make an appeal claim today to get a decision that's ridiculous. in this case, we actually have to have legislative changes because law was last written no 1930, and we -- are seeking updates that went through the house and it passed
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the senate. now that senate version needs to go back to the house and expect in september when they return we'll get that law changed. that will gives new room are to innovate around appeals. the third priority that we're focused on is to modernize the v.a. so this is a pretty big area but this means moted earnizing our approach to i.t. system it is means modernizing our facility. modernizing our best practice, management practices, so we've updated our accountability practices our hiring and firing practices. we're beginning to update our i.t. systems, these are decisions quite frankly that have been put off for decades when i looked at our i.t. decision there have been 17 years ago blue ribbon panel congressional hearings, consulting reports saying v.a. needed to move towards a system that would allow a more modern
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system. but we put that off for decades and patrick are said what we're trying now to do is no longer put off decisions. and so when it comes to modernization question need innovation to help bring our system up into the most advance technology and ways of serving our veterans. the fourth area that is a priority is to focus our resources differently v.a. can't be everything to everybody. and so we're focusing now on those services that are critical to veterans. those are ones that frankly aren't done well in the private sector. but are important to people who have served. so ptsd prosthetic blind rehabilitation -- [sirens] okay. now -- the question is what do we do? do question --
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let's see if somebody comes to tell us -- >> may i have your attention please a fire emergency have been reported in the building please leave the building -- i guess -- you think we should? >> what? >> they're telling me i'm okay. so -- don't choir about me. but i guess we should probably should leave, right? sorry about this. but i think we should probably exit the building. [sirens] i was informed that there was not actually a fire that was her saying that i was going on too long. [laughter]
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so -- so i'm gong to be very short? just finishing up my introductory remarks our schedule is thrown off because of the fire alarm so i was describing these five priorities and i was on the fourth priority which is to focus our efforts in v.a. in a different way. and to focus on what we're calling our foundational service ises those services that are critical to veterans that aren't really replicated in the private sector. and we're talking about things that impact people that -- that serve like ptsd rehabilitation services but we also are thinking about other o types of things that we consider foundational. our approach towards primary care which is a much more comprehensive roach our integration of behavioral health
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issues into primary care we believe is a model that is not readily available in the private sector so we consider that foundational. i mentioned military environment environmental exposure so we have a list of foundational services so we're twal using a strategy now where i've -- said to the leaders in v.a. that talking about investing in services to make them world class polytrauma would be another example to make these services really rise to double down on these services that we call foundational. it is not enough to talk about it. you actually have to invest in them and that means when you listen to a leader, follow the money. follow where they're spending their money and investing.
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so i'm requiring every one of our facilities to move money from nonfoundational services into foundational services. and this year we'll move three and a half billion dollars from nonfoundational services into investing and foundational services. and that's when you can tell that an organization serious about a strategy. so that's our fourth strategy and the fifth strategy which is the only clinical priority that makes it into the five is to reduce veteran suicide. and this is really something that i think is absolutely unacceptable that 20 veterans a day almost one an hour will take their life through suicide and i will tell you, this is to many of us and i'm sure a lot of you share this. this is just -- absolutely heart wrenching every time it happens. as some of you may or may not know who are more involved on
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clinical side, veterans tend to come to a v.a. either drive their car or come to the v.a. and actually suicide on our property. for a number of reasons not all of which i completely understand but one of them being they don't want their families to have to discover them. they know if they're discovered a the a v.a. that we will handle it in a proarpght proarpght appropriate way and take care of them but every day i'm notified of more and more of these that happen, and so -- question just have to do more. we have to do better. we have with to innovate. i know several of the innovators in the audience today are working on that area. but the whole point of why i'm describing 13 areas of risk our strategy of being transparent about our problems so we can find solutions and these five priority areas hoping that you
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can remember are five like yotd greater choice, modernizing our system improving timeliness, investing in foundational services, focusing on them and veteran suicide, is because this is really where we need you to innovate on and way we solve v.a.'s problems and we make us a sustainable, stronger system for our country's veterans one that i believe is absolutely essential to our national security for us to fulfill this mission. so again i want to thank you and i'm excited about all of your energy and ideas that you're contradicting and we'll look forward to being updated on everything that you're doing so thank you very much. [applause] >> thank you so much. >> today beginning at 6 p.m. eastern, on american history tv,
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robert talks about the life of civil war quarter master general montgomery c megs at 10 p.m. real america shows two advocacy films from thed mid-1950s. about traffic and road safety. >> we need proper traffic accident regulations to promote efficient and one more thing too. we're talking of state driving. cars and roads have improved. but the driver must improve too. almost as great a challenge to communities as the road itself. just how can communities go about a safety program? sunday, starting at 6 p.m., on american affects a behind the scenes of the smithsonian castle on national mall and 6:45 p.m. u.s. commission on civil rights marks anniversary of the americans with disabilities act with a report on its history. and work that remains. american history tv, all weekend, every weekend only only c-span 3.
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education secretary betsy delaware vas and a andrea cast tay held a briefing on work force development while many new jersey yesterday. this was after the two met with president trump to discuss an executive order issued in june that would streamline education and work force programs and apprenticeship opportunities. this is just under 20 minutes. >> good afternoon everyone. today secretary of labor alex acosta and secretary of education betsy delaware vas gave an update on work force development policies and apprenticeship initiative and secretaries give remarks about their discussion with the president and take a few question. please keep your questions related to o the today's discussion on work force development and re


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