Policy Vets

How Does the VA Continue to Innovate and Compete Moving Forward

January 14, 2022 Policy Vets with Dr. David Shulkin and Louis Celli Jr. Season 2 Episode 2
Policy Vets
How Does the VA Continue to Innovate and Compete Moving Forward
Show Notes Transcript

Rob Thomas, who is the former Assistant Secretary for Information Technology & Chief Information Officer (SES) for the U.S. Department of Veterans Affairs, talks with Secretary Shulkin and Lou about his time at VA, how the Cerner implementation decision was made, and what VA needs to do in the future to compete.



Rob Thomas:

And I got a call that you're being summoned to the secretary's office. And his question to me was okay, the White House is asking questions and they want to know, to what level we are Microsoft Tuesday patched and how up to date are we in? You know, I assembled a quick swipe team and we, we looked at the entire entire enterprise. And, you know, I got to report the we were 97% patched and people are feel real confident about the ransomware. I asked a follow up question. And the question was, well, how many of the servers are involved in that number? And they came back to me and said there were 400 servers that had not been patched. Well, of course, I was not joyous to run back up to the 10th floor to tell the Secretary that you have we only have 3% that are vulnerable, but 400 of those are servers that can literally impact 1000s.

Charlie Malone:

Welcome to Season Two of the policy vets podcast, engaging with leaders, scholars and strong voices to fill a void in support of Policy Development for America's veterans. With your host, former Secretary of Veterans Affairs, Dr. David Chilton, and the Executive Director of Policy beds, Louis Celli, today's guest Rob Thomas, the former assistant secretary for information technology and Chief Information Officer for the US Department of Veterans Affairs. Mr. Secretary,

Louis Celli:

I gotta tell you, I'm really super excited about Rob Thomas, today's one of our scholars.

Dr. David Shulkin:

Yeah, absolutely. Rob's a real knowledge, source for anything it related to the federal government. He's been doing this work forever. And he's just a great guy, because he knows everything about the way things work and don't work in Washington. Well,

Louis Celli:

you you've got some, you know, some long standing confidence in him. You hand picked him for some assignments, didn't you?

Dr. David Shulkin:

Yeah. When I became secretary, he was the guy I went to to say, look, it is going to be a big part of the transformation of VA, and I want you to be in that lead role. So he was my acting CIO for VA. And, you know, he had the confidence of his staff. He knew what he was talking about, doesn't have a political bone in his body. So it wasn't playing games just sort of wanted to be there for his fellow veterans.

Louis Celli:

Yeah. I mean, if he's got a rich, rich history in the IT community, I mean, not only did he do, you know, a full career with the, with the Air Force in the Air Force, National Guard, you know, he's got a full full government career as well. I mean, he's bounced around, you know, to a couple of different agencies. He retired out of VA, didn't he?

Dr. David Shulkin:

Yeah, he did. He he left not too long after I left. And I think that it didn't surprise me long. He didn't sit around the home for a long time. But he jumped right back in and trying to help improve the way the government works. But this time from the private sector, and we need people with his inside knowledge working to make those connections between the private sector and agencies like VA, because that's what it's going to take this is not a government only type of solution, you need to have that innovation coming from the private sector.

Louis Celli:

No, it's 100%. Right. So he's with Lycos now. And, you know, I think, you know, just out of respect for him, you know, we should probably, you know, we should probably be careful about what we talked to him about when it comes to some of the current contracts that they're engaged in. We don't want to we don't want him to feel uncomfortable during the interview. Well, I

Dr. David Shulkin:

think it's more important that we hear from him what he thinks is the right direction for the agency. And, you know, I'd rather hear his candid thoughts on what to do often, when you get a chance after you've been involved in government for so long, you get a chance to sit back and reflect, you have some of those new perspectives on. Boy, I wish I wish I had only thought this way when I was there running the agency. So be interesting to hear how he's thinking about the IT world and how he's thinking about VA now that he's had the chance to be on the sideline.

Louis Celli:

That's a good point. Now, when you hired him, did you guys have any idea that you would be faced with a transformation opportunity? You know, that that you had to make a decision on when it comes to either picking Cerner or sticking with VISTA or or some other solution? Did you see that coming?

Dr. David Shulkin:

Well, oh, not only did I see it coming, I brought it on. When I was in the Obama administration. I can't tell you how many countless meetings I had where I understood that nobody in the room was prepared to make the hard decisions when I went back and I looked at the issue of whether VA and DoD should be working together on the same IT platform. There had been calls in Congress from before 2000. So I had been there. Now 17 years later, and the same conversations have been going on. And nobody likes to make the hard decisions. So I decided, when I was secretary, I wasn't going to waste the day that it was those decisions that needed to be made, that I wanted to make sure that we had all the information and that we had lined up the real type of data to be able to make those calls and then make the White House and Congress and the veteran service organizations in the veteran community aware of the choices and so so Rob was an important part of putting together the data, understanding the history, understanding what the future looked like, in order for me to move forward on some of those decisions.

Louis Celli:

Yeah. So you know, speaking of Cerner, we're going to have to get them back in eventually, because there's been a huge shift in, you know, in the project now that Cerner is being wooed by Cisco, to be bought out, and that's going to change the dynamic of the entire the entire rollout.

Dr. David Shulkin:

Well, first of all, it's Oracle, so or Oracle Oracle's gonna be acquiring Cerner. But I think you're absolutely right, this is a big change. We're now talking about a new major entrant into the federal space that's responsible for the oversight of the Department of Defense, the Department of Veteran Affairs, other federal agencies, and we need to really understand not only what the vision for this is, but what the implications are going to be. And I'm think you're right, I think that our listeners are going to want to hear a lot about that. And we certainly are going to want to bring some of those leadership, people on the policy vets podcast to talk about that issue.

Louis Celli:

Yeah, I think Congress is gonna want to hear a lot about it, too. And, you know, maybe we can get somebody from Oracle to, to join us on the podcast and hear it from their perspective as well.

Dr. David Shulkin:

Absolutely. I think that today's conversation is a good setup for that. And this is an issue that both you and I and the rest of the policy vets team is going to be following very closely.

Louis Celli:

I can't wait. So yeah, so let's get Robin here. Great. Hey, Rob, thanks for joining us. And welcome to the policy. That's podcast.

Rob Thomas:

Thank you. And good morning from Montana, where yesterday, it was 31 below. And it's been pretty sporty with all the snow and cold weather over the last couple of weeks.

Dr. David Shulkin:

Rob, it's great to see. And by the way, that's why we love our veterans from Montana, because you got to be very, very tough. Yeah, live out there and make it through the winters. So it's the beginning of the year. And we couldn't think of a better guests that have the new to start off our season. Because as you know, the VA is such a big organization. And it is such an important part of the way that you run a system as large as the VA. So before we get into some of the specifics, can you just tell us a little bit about the IT organization at VA, what it covers how big it is, what its budget is to give people a sense about how that organization runs.

Rob Thomas:

It's great to see you again, sir. In the YMT. You know, there's there's really a history that goes goes to it their firm, for many, many years. You had a VHA and a VBA. CIO, and you had it and all the VA MCs, they'll work for the medical center directors, they stood up visions in in the 1990s. And of course, everybody's aware of that. But the point here is when they did that they hired CIOs and each one of the divisions. We had CIOs at each one of the VA MCs. We had CIOs All Over The Air Force. In fact, we had hundreds of CIO. So we had conflict and duplication and overlap all over the place. Congress acted that you wanted to centralize it. It was a pain point for a lot of the people in the VA but it did centralize the IT resources and people. But back to my original point, the network and the infrastructure and the VA grew up around those constructs. They were all separate. They were all disparate. I came back to the VA in my second stint. And I went to St. Petersburg, which is where I figured I'd spend some great years down there at Bay Pines, and then go off into retirement that didn't work out. Well. For me. I was there for six weeks and Guy seven back to Washington DC, unfortunately for me, but when I got up to Washington, DC, and I was setting on the Enterprise cybersecurity strategy effort that was going on for 20 weeks for the Secretary the hill, in the White House, I was running into some IT issues and the people have a code, the headquarters couldn't work on my PC, because was provisioned in, in vapourised. So you can see with 1000 employees in IMT, about 8000 contractors covering all 50, United States and department that's 400,000 that really has 500, some 1000 people on the network at any given time along with the Philippines, Guam, Puerto Rico. It's a vast network. And it's a very complicated network. And the folks know it do incredibly well with what they have.

Dr. David Shulkin:

Well, Rob, fortunately for me, you did get summoned back to Washington, because when I became Secretary, as you know, I asked you to take on the role of the Chief Information Officer. And there was nobody I trusted more and thought had a better handle on what was happening in the VA. So thank you for all of your service and what you did for the VA. But how large a budget is the O i NT at the VA

Rob Thomas:

nominally runs between four and a half to $5 billion, depending on the year, one of the years you and I were there, it took a decrement of 220 million. So it's a little closer to for another year, when we were there was closer to five. So it usually runs somewhere between four to$5,000,000.04 to $5 billion is within the IT budget.

Dr. David Shulkin:

Yeah, I just wanted to follow up on one of the issues that you mentioned, because a swing between decentralization, VA used to have a very decentralized model, that there are so many disparate IT systems in the VA literally hundreds of them, as you had talked about earlier. And yet, when you look at what's happening in the private sector, there are so many companies innovating startups bringing new it innovations. How does the VA stay? Cutting edge? Does it need to continue to work with all these younger companies and continue to bring in new systems? Or can it stay innovative by internally innovating?

Rob Thomas:

So that's exactly right, the VA, overall VHA VBA all grew up in a very decentralized execution model. We were we were in they continue to strive towards in an enterprise centric model. Those dos instances 220 230 instances are still there. You and I went to a lot of planning meetings to move a lot of that to cloud. And when you and I started down the business cases for the EHR on which direction we were going to go and we had four different avenues that we were looking at one of those was going to centralize a single instance into the cloud. That never did happen. And they continue today. Still with with those 130 different instances supporting the VA MCs across the VA. So it is still a decentralized model going to Cerner, clearly, it will be a centralized model, the enclave for the DOD and the VA is in the same same place. same location, same protected environment. So it will go with the new electronic health record for Cerner into a completely centralized model. But Vista today is still a decentralized model.

Louis Celli:

That really brings up a really good point. I mean, you've got an extremely extensive career in IT VA wasn't the first CIO position you held and, you know, besides just the sheer size and scope, can you tell us, you know, what you found to be major differences between say, being the CIO of FEMA, or be in the CIO of VA?

Rob Thomas:

Yes. So completely different in in so many in so many ways. The the comparable, you know, from female to the VA would would probably not be a fair one. The FEMA organization is about 40,000 FTE. Compare that to the VA with with 400,000. And we always have another There's 100,000 or so on the network that are in training their volunteers, they're doing internships. So when you see the numbers printed in Washington DC on the size of the Department of Defense, Department of Veteran Affairs, that's not the size and the population that the CIO serves, because there are a whole lot of other people involved with that. And FEMA would be dealing with 10 to 20 programs going around to the missionaries with a hat in hand being completely different. I had 700. In some complicated programs going at any given time, I had an organization called the Enterprise Program Manager mid office that had 750 program managers, we were dealing with health benefits, cemetery, corporate systems, finance, supply chain, logistics, on any given day, I could have 17 meetings and be dealing with 17 different programs. So the comparables between the VA and the femur are much different, you know, 10 times the magnitude between FEMA and the CIO. Probably a more comparable experience for me was before 911 during 911 and after 911, I was the airforce deputy CIO and Deputy Chief of warfighting integration, of course, located in the Pentagon, population size, almost exactly the same. budget wise in Air Force was about 11 billion for it that I was leading. We mentioned the VA, four and a half to five. So it was less than half, I had somewhere around 75,000 FTE at the Air Force leading the IT and the VA had 8000 people. So I can tell you the whole story around that. But when it did become a centralized IT model in the VA. I've always felt the Secretary will hear me say it often, as we grow call centers, as we grow new missions, we need to grow the consummate O and M operation maintenance in the out years with gains in it. And it hasn't happened for a long, long time. And you know, it's been a slippery slope and probably why you read about a lot of the IT outage and outages that you hear about.

Dr. David Shulkin:

Yeah, Rob, one of the challenges that I'm sure that people are aware of is given how competitive it is to hire people in the technology field right now and the talent. It's so competitive. How were you able to make sure that VA or other federal agencies had the talented software engineers and other people because, frankly, the salaries that the government pays just can't even begin to compete with what the private sector was doing?

Rob Thomas:

No, you're exactly right. We're all competing for the same, the same talent pool. And when you have the Googles, and you have Microsoft, and you have IBM, it's very difficult in government to compete for those. You know, what really helped me is, as Lou mentioned, me being in the IT career field for 40 years, when I came into the, into the VA CIO role I was over 30 years, I had a lot of people that followed me into the VA and a lot of people that follow me into FEMA. And that's, I've had a lot of people follow me now here to lie to us, quite frankly. So that's part of it. But then in addition, you know, we worked with with with OMB and the White House, and we did come up with it. allowances, you approved me getting a Cisco in and a lot of sense of staff that were being paid above the government normal was the only way I was going to get that type of talent because they were competing to take in the Capital One in different baking systems. So the bottom line is, is I spent a lot of time on talent management and the resource management of the folks and I was actually a big recruiter myself in the top job. I had to be aggressive to recruit the talent that we needed didn't just happen by putting out a job announcement. You have to be actively involved to get the right talent and the right skills to support the veterans, because it's the most important place to work in my view in Washington, DC. Yeah, I

Dr. David Shulkin:

think, you know, Rob, you're so right. When I think about how I spent my time I spent my time. A lot of my time is recruiter in chief trying to convince people that coming to serve our veterans, the mission that we were doing was worth them making a personal sacrifices for their income and their family and, and if you're not personally committed to bringing people on board like that, you're not going to have a great organization.

Rob Thomas:

Completely, completely agree.

Louis Celli:

That's a really good point. And, you know, earlier Rob, you talked about how, you know, VA took a decentralized, you know, it program and tried to centralize it. You oversaw, you know, between four and a half and $5 billion worth of the budget. Were there any IT programs or budgets that didn't fall under your your purview,

Rob Thomas:

according to the law? Absolutely not because centralised it means to see iOS haul it. Otherwise, we'd be in violation of the law. And we had plenty, we have plenty of oversight. But I would say I wasn't naive, there's always shadow IT the shadow it in every business in every organization. It was it was important to learn about those and get him on the on ramp, you know, is quickly in as soon as possible. But you know, while I was there, we ended up getting 100% visibility of everything we had on the network. And you know, we could talk about an event, the Secretary and I went down that pathway on on ransomware was with the White House. But we we might not end up getting there. But I had if you go on to the VA network, when I was there, and now you have to have an authorization to operate, you have to have an ATO, you have to have all of the right artifacts, you have to have the right scans, the right testing, anything that does come on the network that we have not already nominally approved, you know, using aggressively get involved with that. So the law says that I had oversight over everything, everything that went on the network, and all it ends up on the network, I felt like I oversaw the vast majority of it in where we did have shadow it, you know, we tried to normalize that and help them do the right policies and procedures. So it would succeed. So I would say yes, that's why the law was written the way it was.

Dr. David Shulkin:

Rob, you've talked about the shadow it a couple times. And I think there's probably going to be some people wondering what is that? And, you know, I think what's important to know is that that these underground efforts to launch chai tea programs and to innovate, have been part of VAs history really since the beginning. And in fact, it was shadow IT effort that started the first electronic health record in the VA called VISTA. And just thinking a little bit about that when I got to VA and started to see patients myself in the VA, as a doctor, I got to use VISTA. And frankly, I liked it a lot. It was a very usable, friendly system that wasn't that difficult to learn. And so one of the hardest decisions I had to make when I was secretary was whether we would continue to the keep Vista a active system to be able to upgrade it to be able to maintain it. And as you know, I decided to move in the direction of moving towards a commercial system rather than maintaining this system that I felt was increasingly growing outdated and difficult to keep up. But I just wonder now that you've had a few years to think about this, what was your perspective on keeping Vista maintaining it versus going to a commercial system?

Rob Thomas:

Well, I started in the VA when when I was much younger and didn't have the gray hair that I have today and you know, I attended mumps beginning and mumps intermediate that divide the hinds VA AMC out of Chicago, Illinois, and I was actually a mumps programmer and I was assigned to Fort Harrison VA Medical Center, right outside of Helena Montana that you and I visited was centered to test her. And I was programming the clinics, pharmacy lab and all of those things. So I grew up around mumps and I grew up around. It was DHCP and then while I was actually there changed to VISTA, but it was the decentralized hospital. Computer Programming. You're exactly right. The hardhats did that all underground and they developed it and they evolved it and they made it the number one EHR in the nation, bar none and I was I was right there along with them. I want to be the CIO to Health Administration Center which does chant VA, all of the claims processing down there. We use Vista I was saying I was a VISTA zealot myself so no speech disk sessions were going on, I had already gravitated back to this, and I was overseeing Vista evolution. And then we went down a pathway where we did the digital veterans platform. And we really proved out that we could do incremental improvements in Vista, we could open it up with an API gateway. And we could do a whole lot of complete health in the veterans journey within from their home to work, working in the commercial health space back to the VA. And we really prove that I really felt like that was a strong future, and a strong way to go. But quite frankly, the decision was made for us years before when the DoD decided that they were going to go to Cerner. It was time for all of us to be on the same exact EHR. And you remember, sir, I was very adamant that it had to be a single instance, because my view was this when you came into the military, and you listed or you went through commissioning, you were then through your military service record discharge retirement, you were then right, still in the same exact place in the electronic health record. And the VA manages you all the way into you go into our incredible cemeteries at the end. So it would be from cradle to grave, you had one electronic health record following you, I still have issues with my electronic health record for my 27 years in the Air Force. Everybody does, this solves that the DoD made this decision to go that direction, it forced us to go in that direction. That's the direction we're going in. But I was a huge fan of VISTA and I still am.

Dr. David Shulkin:

Yeah. And I think that was the difficulty that people may not understand the complexity of this decision. This was not certainly any indication of the value of Vista, because I know you valued it. And I value that and we know the VA clinicians loved it. This was that one of those decisions that are lonely at the top that you have to take a look at and say what about the future of this organization a decade down the road, and we knew this would be so controversial, as you remember, you are one of the few people really looking at the inside details. I made everybody in VA sign NDAs even to talk about this issue, because I knew how controversial this would be. But, you know, I think that this is an important directional issue for the federal government and, frankly, for the millions of veterans that rely upon the VA. So I know both of us hope that this goes well over the next several years as this is a big priority for VA.

Louis Celli:

You know, I can I can tell you, to Rob's point to, you know, having having really advocated for this for over a decade, the VSOs were were pretty adamant about supporting Congress's and earlier administration's views that there should be a single seamless lifetime electronic health record. And you're right, Rob, you know, once once DoD pulled the trigger and made the decision to go commercial, the VA really didn't have much of a choice at that point, you know, they, they either had to come up with some sort of extremely creative way to knit all of those disparate systems within VA together to be to become one and then turn around and knit that together to match do DS platform, which I mean, it was, it's a big ask, and it would have been an endless and really just a never ending effort. And something else that you talked about was the the ransomware. And I know that that's going to pique a lot of people's interest, listening to the podcast, and we've heard before, you know, between things like last computers, and you know, such as someone who has had a cat card, and has gone through the security training at VA, I know how stringent it is and how complex the passwords need to be and how often you have to change it. So making the decision then to to combine all of these EHRs Do you see VA later on maybe as being at higher risk of exposure now that everything will be accessible through one portal as opposed to the disparate ones that you talked about earlier?

Rob Thomas:

Well, time both time will tell but my my personal view is, you know, having visibility across across your network, having the right cyber tools process and procedures are the most important thing for for a CIO to be sure. It's the number one thing that kept that kept me up at night. You know, the back to the ransomware I was on the Hill running around, doing a myriad of things and I Got a call that you're being summoned to the secretary's office? And his question to me was okay, the White House is asking questions, and they want to know, to what level we are Microsoft Tuesday patched and how up to date are we in? You know, you rattle off these questions, and I need these right away. And, you know, I assembled a quick SWAT team. And we, we looked at the entire the entire enterprise. And, you know, I got a report that we were 97% patched and people were feel real confident about the ransomware. I asked a follow up question. And the question was, well, how many of the servers are involved in that number? And they came back to me and said there were 400 servers that had not been patched. Of course, I was not joyous to run back up to the 10th floor to tell the Secretary that you have we only have 3% that are vulnerable, but 400 of those are servers that can literally impact 1000s. The security around VISTA, the security around ch CS, the security around Cerner. Is it security Rob Cerner is much more robust than what we've had in the past and the VA around VISTA. And I don't like getting into those conversations. Because when you really start talking about cyber and your CIO and our Cisco and you feel real proud of what you've done, and how well you've protected it, you you invite folks to see how well you really have done and so I, when when when I would give speeches for the Secretary, right? When I'd be on the hill, I'd be very vanilla about the overall cyber because you just you just want to do the very, very best, because protecting veterans data was my number one responsibility. You know, you really do need a big effort in the VA right now to continue to innovate, and really on the IT side, and the and the back, the back end of those eyeties systems. You know, we we learned we have the largest amount of data centers, in government 367, when when I was there, and you know, those are all being run in different ways. So there's conflict and duplication and overlap, there was purposes for him at the time, but 367 data centers is just absolutely untenable. And it continues to be an issue those themes, not don't need to be lifted and shifted in cloud, they need to be retooled, or integrated into other systems. As you know, sir, when I was there, we came up with a comprehensive IT plan and what that was all about was okay, we need to really start decommissioning hundreds of the systems collapsing functionality into other systems. We need to sunset a lot of these systems to free up those it dollars in that four to $5 billion budget. And we need to free up the FTE so that they can start working on new things for the VA. We have nearly 2000 Call centers around the VA, we really need 2000 I wouldn't think so a smaller subset is most appropriate, but then even so much more easy to manage. We'll probably have enough FTE, I felt at the time to support about 25% of the call centers and it continued to pop up all the time without the operations and maintenance tail and without the commencement FTE to support it. So when you were balancing too many programs, too many priorities. And this is why we had so many swats and swats every day, every night and every weekend. And how to Janelle tuna, an outage in Kansas City, an outage in Oakland somewhere Montana where a backhoe cuts a fiber optic cable. We definitely had a lot of systems and a lot of applications across the VA and they need to innovate, they need to shut down a lot of systems, they need to move them to the cloud, they need to shut down these data centers and free up a lot of that money. It's been a challenge the VA, but it needs to happen now.

Louis Celli:

Yeah. So you know, Rob base, I'm going to collapse a couple of questions really into one because this this is the right place in the conversation to do that, you know, with over 700 different programs. You talked about integrating them into different systems. And I don't know if you've done this research, or if you have, you know, a comprehensive answer right now, but just a ballpark of all the systems that VA has. I mean, it wouldn't be possible just to have one platform that serves everything that VA needs to do that that's probably unrealistic and unmanageable, but how many should there be out of the 700? Could you collapse everything down to say 50 or 75 or 400? And I can't even imagine that the savings and dollars in FTE that would that would represent but what would that look like you know based on experience?

Rob Thomas:

Well, before I would testify with the Secretary, you'd say, if you don't know the answer, just make sure you tell him you want to take it for the record. So in coming up with an exact number, my preference would be to take that for the record and get back to you, Lou with what that number should be. But in all seriousness, I would say that, you know, a lot of most IT systems were built from the ground up with a purpose. And that purpose was to serve that mission said, there really wasn't a need for them to do cross mission. functionality. But, you know, the aperture in the world has changed. They were built in silos, and we called them stovepipes. And, you know, we in the IT, people coined the name cylinders of excellence, because we always wanted to make it sound a whole lot better. I would say even the VA, the 700, some were active programs. But we had around 2000 systems, we had literally 1000s and 1000s of applications very comparable, almost exactly as I was saying before, to the Air Force. I can't give you an exact number. But what I would say is, you have multiple logistics and supply type systems. And you have multiple different types of ERP systems. 100 systems, I don't know what the magic number is. But I think when we actually created the Germany lights in the past, we were at 100, and some to around 200, which would be much different than that 2000 number that I just came up with. The challenge the VA is having right now is, you know, they need a platform, they need a lot of things. But they just quite frankly, right now have too many transformations going on. At the same time. You know, when you really look at Gartner and other folks, they talk about a organization in a large organization that can transform one major business area. And then the Secretary, the CEO and the whole entire organization have to be rowing in the boat in the same exact direction. If you look at the VA today, we know all about Cerner and their electronic health record transformation, that's a cataclysmic change across VHA. But at the same time, they're doing a supply chain transformation that is very, very large and valour, they're doing a finance transformation in FM BT and taking out all the finance systems and going through there, I can go into cemetery cemetery right now is replacing boss, the burial system with the nbms. They're bringing in VLM, and cemetery right now. VBA is doing major transformation, all around claims, automate pension, automated optimization with AI and RPA. Robotics process automation. So right now in the VA, if you really looked at it at the macro level, at the secretary level, there are major league transformations going off across the VA in about 10 different areas, and they're very distracted, but those, and they're all running down the road right now. And they have a whole lot on their plate to succeed.

Dr. David Shulkin:

Rob, I know when you spend your life the way that you have in federal agencies and so much of your career focused on public service when you finally leave. And now you're in the private sector. Is there any one thing that you feel like is unfinished business that you wish that you had been able to see through to fruition that you think about sto

Rob Thomas:

Yeah, and it's it's probably controversial, but you know, I would have, I would have liked to have seen the Cerner electronic health records through and, you know, when I left, I really made a big effort. When you and I have a lot of really difficult discussions late at night, with the undersecretary of health with Poonam who was a great partner for me through that entire journey, we we really wanted to see that through and one of the decisions that I made in the background that you all were not really aware of was, I said, if we're really going to succeed with the VA, we're really going to have one instance, we need one instance. And we don't need a single common system. In fact, I want us to make sure we have the same identity management that the DOD does so that we don't get into issues down the road. I want to make sure we have the same certificate authority. And in fact, I'd even like to go to the CatCard so that when you go into an MTF or VMC we really have a seamless, military active duty veteran experience and you know, I left the VA and that was a leftover retirement for family reasons and, and retired from federal service after 35 years. But I would have liked to seen that all through because the VA then fell back to their own certificate authority and their own identity management and making it more difficult than it should have been. If we're going to one system, let's go to one system. And let's not make it more difficult than it has to be. Let's make it a seamless experience for the for the military member in the veteran going forward in the future. So I would have liked to have seen the server implementation.

Dr. David Shulkin:

Absolutely. I think that's a great place to wrap it up into Thank you, Rob, not only for your time today, but for those 35 years of amazing public service. And I know you're continuing to contribute in many different ways from the private sector. So we look forward to staying in touch and thank you for joining us on policy that

Rob Thomas:

Absolutely sir. Thank you so much, and Happy New Year.

Louis Celli:

Yeah. Thank you, Rob. This has been very eye opening. Thank you. Happy New Year to you too. And that is it. That really is all the time that we have for today. Join us next week. You're not gonna want to miss this podcast. We have retired Air Force Brigadier General and sitting congressman from Nebraska. He represents Omaha and his name is Congressman Don bacon. This is going to be an exciting podcast. You won't want to miss it and see you next week.

Charlie Malone:

Thanks for listening to the policy bets podcast. For more information about projects and other podcasts go to policy vets.org