An Autoethnographic Account of Innovation at the US Department of Veterans Affairs

The history of the U.S. Department of Veterans Affairs (VA) health information technology (HIT) has been characterized by both enormous successes and catastrophic failures. While the VA was once hailed as the way to the future of twenty-first-century health care, many programs have been mismanaged, delayed, or flawed, resulting in the waste of hundreds of millions of taxpayer dollars. Since 2015 the U.S. Government Accountability Office (GAO) has designated HIT at the VA as being susceptible to waste, fraud, and mismanagement. The timely central research question I ask in this study is, can healthcare IT at the VA be healed? To address this question, I investigate a HIT case study at the VA Center of Innovation (VACI), originally designed to be the flagship initiative of the open government transformation at the VA. The Open Source Electronic Health Record Alliance (OSEHRA) was designed to promote the open innovation ecosystem public-private-academic partnership. Based on my fifteen years of experience at the VA, I use an autoethnographic methodology to make a significant value-added contribution to understanding and modeling the VA’s approach to innovation. I use several theoretical information system framework models including People, Process, and Technology (PPT), Technology, Organization and Environment (TOE), and Technology Adaptive Model (TAM) and propose a new adaptive theory to understand the inability of VA HIT to innovate. From the perspective of people and culture, I study retaliation against whistleblowers, organization behavioral integrity, and lack of transparency in communications. I examine the VA processes, including the different software development methodologies used, the development and operations process (DevOps) of an open-source application developed at VACI, the Radiology Protocol Tool Recorder (RAPTOR), a Veterans Health Information Systems and Technology Architecture (VistA) radiology workflow module. I find that the VA has chosen to migrate away from inhouse application software and buy commercial software. The impact of these People, Process, and Technology findings are representative of larger systemic failings and are appropriate examples to illustrate systemic issues associated with IT innovation at the VA. This autoethnographic account builds on first-hand project experience and literature-based insights

Imagine the future world: How do we want to work tomorrow?:Abstract proceedings of the 16th EAWOP Congress 2013

The contributions summarized in this volume have been presented at the 16th Congress of the European Association of Work and Organizational Psychology (EAWOP) in Münster, Germany, May 22-25th, 2013. The bi-annual EAWOP Congress is one of the largest international conferences of work and organizational psychologists worldwide, and the largest in Europe. For the current congress, more than 1.700 abstract were submitted that were subject to a double-blind review process. The theme of the EAWOP Congress 2013 “Imagine the future world: How do we want to work tomorrow?” particularly focused on new challenges that we experience in work organizations today and tomorrow, such as globalization and digitalization of economic processes, flexible work with remote partners, demographic changes, financial turbulences, and growing climatic problems. Providing new and innovative ideas on mastering these challenges, this congress was not only a stimulating event for the community of work and organizational psychologists, but also offers new ideas and concepts for decision makers in related disciplines, consultancies, and politics