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VA Office of Integrated Veteran Care

Case Study

Department of Veterans Affairs improves access to care

  • One centralized customer relationship management system
  • Two weeks to develop a working prototype – which previously took months
  • 600K+ beneficiaries supported

“The Pega team did a wonderful job… They came back in two weeks with a working prototype and showed us the art of the possible… In two weeks they developed something that was useful to us.”

The Business Issue

The Veterans Affairs Office of Integrated Veteran Care (VA OIVC) is on a mission to fulfill President Lincoln's promise of caring for veterans, their families, caregivers, and survivors. With over nine million enrolled veterans and an annual service count exceeding six million, it’s the largest integrated healthcare network in the United States.

But homegrown legacy systems, disparate processes, and siloed data challenged the organization. Without a unified customer relationship management solution, clinical contact center staff needed to simultaneously navigate multiple disparate applications to access all the data and tools necessary to fulfill veterans’ needs. To top it off, fielding 45 million calls annually wasn’t an easy feat – the organization knew it needed to transform to reduce backlogs and improve access to care.

The Solution

The VA OIVC identified its Meds by Mail program as a starting point for optimization. It collaborated with VA pharmacists, technicians, and members, using Pega to develop a working prototype that streamlined operations and improved access to care. This was accomplished in just weeks compared to a previously months-long development type.

The agency then expanded its use of Pega to integrate multiple systems and streamline operations. It created VA Health Connect CRM, a centralized customer relationship management tool that enables nurses and schedulers to access pertinent information without navigating through numerous legacy systems. Its user-friendly interface reduced handle time and improved the overall experience for both employees and veterans. VA OIVC even used Pega's data analytics capabilities to drive process optimization – identifying bottlenecks and facilitating data-driven decision-making.

VA Health Connect now serves as a centralized platform for scheduling appointments, managing medications, and providing clinical triage for veterans. It even facilitated the adoption of alternative modalities, such as telehealth and video visits, ensuring veterans could receive care remotely without compromising their safety during the COVID-19 pandemic.

The Results

  • Established one centralized customer relationship management system that eliminated the need for staff to log into multiple disparate systems for claims research and validation
  • Two weeks to develop a working prototype – previously a months-long process
  • Less than four months from prototype to solution delivery
  • 600K+ beneficiaries supported

The VA OIVC has a solid foundation for future modernization efforts, ensuring it can rapidly respond to emerging needs and provide timely care to veterans for years to come.

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Industry: Government Product Area: Platform Solution Area: Enterprise Modernization
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