ANALYSIS | BY ERIC WICKLUND
FEBRUARY 15, 2022

SAINT LUKE’S GIVES NURSES THEIR OWN VIRTUAL CARE UNIT

ANALYSIS  |  BY ERIC WICKLUND  
   FEBRUARY 15, 2022

The Kansas City-based health system has opened an inpatient virtual nursing unit that is managed almost entirely by nurses, and is fielding calls from health systems across the country interested in the concept.

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KEY TAKEAWAYS

Saint Luke’s Health System has opened a unit in one of its hospitals that is managed virtually by nurses operating from a high-tech command center in downtown Kansas City.

The wing, built on a telemedicine platform designed by Teladoc Health, allows nurses to remotely monitor patients and handle a lot of the administrative work that typically leads to stress and burnout.

The virtual nursing unit has helped the hospital increase both patient and nurse satisfaction rates while improving discharge time and reducing ED waits for a hospital bed.

A Kansas City–based health system is putting nurses at the center of the virtual care platform and seeing positive results not only in patient and nurse satisfaction, but clinical and business outcomes as well.

Saint Luke’s Health System opened its virtual nursing unit in 2018. Launched by Susie Krug, chief nursing officer at Saint Luke’s East Hospital in Lee’s Summit, Missouri, the unit sits on a telemedicine platform built by Teladoc Health and managed by nurses at the health system’s technology center in downtown Kansas City.

“It’s a new model of care,” says Jennifer Ball, the health system’s director of virtual care. “It’s there to [help] the nurses as well as the patients, with a focus on virtual care. Virtual everything is going to be our future.”

Saint Luke’s isn’t new to the telehealth bandwagon. The health system, which earned Digital Health Most Wired recognition in 2021 from the College of Healthcare Information Management Executives (CHIME), has been using digital health tools and platforms, ranging from virtual visits to an eICU program, for close to two decades. But the virtual nursing unit is a relatively new idea, in use in only a handful of health systems around the country.

It was designed, Ball says, with the idea that nurses are often the focal point of care in the inpatient wings, handling different tasks in between and around rounds and visits made by doctors and specialists. Nurses have the most contact with patients and their families, handle the administrative and educational tasks, manage bedside devices and data-gathering, even lend a hand with everything from the meals to the TV, she says.

That kind of work is why nurses have been rated the most trusted profession for 20 straight years by Gallup, but it’s also why so many are dealing with stress, anxiety and burnout—and why health systems are having a difficult time filling those positions. Add in the challenges of protecting both patients and care providers during a pandemic, and the job becomes tougher.

Due in part to the shift to virtual care caused by COVID-19, many health systems are rethinking how that strategy can be scaled and sustained beyond the pandemic—not only outside the hospital but inside as well.

Saint Luke’s virtual nursing unit operates on the idea that many of the tasks performed by nurses in the inpatient setting not only are repetitive but inefficient, and that a telemedicine platform that connects every room in the unit can allow nurses to manage those tasks from one place. Nurses and staff on the unit would then be freed up to focus on patient-facing care, while those in the command center would monitor the patients and enter data in the medical record.

“They chart in the same system,” Ball points out, “so everything is right in” the EMR.

Early results show positive outcomes for the virtual unit. Patient satisfaction is high, and patients are discharged within two hours of the discharge order, some 20% faster than in other units, and they’re also out of the hospital before noon at a 44% faster rate. This, in turn, reduces the wait time for patients in the ED and reduces the time to treatment.

Turning those metrics around, health system officials say the unit has boosted nurse morale as well, improving workforce engagement, reducing fatigue (physical and intellectual) and even improving Saint Luke’s recruitment capabilities.

Ball says the health system learned quickly that a virtual nursing unit is different from any other virtual care program. Workflows must be designed specifically with nursing in mind, and often go through a few iterations before working out.

“We’ve changed what the virtual nurse does several times,” she says. “It was challenging at first because this is a new model, and we had to learn what works and what doesn’t work. And while this is [modeled] as an observation unit, it has been anything but that over the past year. “

Ball says Saint Luke’s had the advantage of launching the program in a new, specially designed unit, rather than integrating it into an existing wing. She expects to integrate virtual nursing to other wings in the future, and to deal with new challenges as they expand the footprint.

“There will be some culture change involved,” she says.

For that reason, Saint Luke’s launched its own virtual nurses training program about a year ago, with the idea that nurses should be trained specifically in virtual care rather than brought over from another area of the hospital and introduced to it. With virtual care the emphasis is more on technology, as well as on communication. After all, sitting in a command center surrounded by six large monitors isn’t quite what nurses are taught to expect in school.

“For some of the nurses, it’s a lot, but for others not so much,” Ball says.

And that’s why education and team-building are so important to the program. Unlike many doctors, nurses work in a team setting, with the understanding that care coordination and management are group-based rather than individual goals.

“You need buy-in from nurses at the beginning,” Ball says. “You can’t start too early with education … and team building. In some cases, you have to sell what a virtual nurse can do,” but once they see what is possible, they’re invested in the program.

That goes for the patients as well. Many might wonder whether a virtual nursing unit isolates patients too much, depriving them of the in-person care that helps them adjust to being in a hospital and puts them on the path to recovery. But Ball says patients have come to appreciate the idea that they’re always being looked after, and they develop connections to their virtual nurses. They identify more closely with those nurses than with the nurse who shows up when someone pushes the help button.

Just as Saint Luke’s checked in on Ochsner Health’s virtual nursing model as it was developing its program, Ball says she’s fielding requests from other health systems who want to adopt that strategy. And she has an eye to the future as well, including integrating the virtual nursing model into existing wings and hospitals in the system.

“There’s always new technology as well,” she says, eyeing the fast-developing telemedicine landscape and the emergence of digital health tools, including wearables. “This [model] is going to be used in new ways in the future,” such as mentoring and precepting, and integrated with other services such as the pharmacy, social workers, dietitians, and chronic care management.

Eric Wicklund is the Technology Editor for HealthLeaders.

Article link:
https://www.healthleadersmedia.com/innovation/saint-lukes-gives-nurses-their-own-virtual-care-unit

February 13, 2022 13:00, Last Updated: February 16, 2022 14:39

By Andrew Thornebrooke

Bureaucracy and waste are hamstringing U.S. militarydevelopment and adversely affecting the nation’s military readiness, according to the former chief software officer of the Air Force. That means the United States is less prepared for a potential conflict with China.

“Any bureaucracy which slows down outcomes for the sake of bureaucracy is going to ensure we get behind China,” Nicolas Chaillan, who resigned in September, said in a recent interview.

“China doesn’t let complacency or bureaucracy get in the way of [its military],” he told The Epoch Times.

He made the comments amid increasing tensions between the United States and the Chinese Communist Party (CCP) concerning the de facto independence of Taiwan, mass intellectual property theft, and human rights abuses in Xinjiang and elsewhere.

As that competition becomes more adversarial, the CCP has focused on technological development in sectors that its leadership considers vital, such as artificial intelligence (AI) and machine learning (AI/ML).

According to Chaillan, it’s these sectors, and IT more broadly, that U.S. military bureaucracy is negatively affecting the most.

A ‘Toxic’ Budgeting System

There are long-running concerns that the Pentagon is encumbered with red tape, redundant oversight measures, and safety protocols that slow military development to a snail’s pace. Indeed, the bureaucracy has become something close to synonymous with the Department of Defense (DoD), according to its leadership.

Gen. John Hyten, vice chair of the Joint Chiefs of Staff at the time, said in October 2021 that the Department’s bureaucracy was “brutal,” and that a risk-averse culture among military leadership was stifling technological development and allowing the CCP to seize the advantage in critical sectors such as hypersonic weapons development.

“The pace [China is] moving and the trajectory that they’re on will surpass Russia and the United States if we don’t do something to change it,” Hyten said. “It will happen.

“We can go fast if we want to. But the bureaucracy we’ve put in place is just brutal.”

When asked if he agreed with that assessment, Chaillan’s response was matter-of-fact.

“Yes, without a doubt,” he said. “Everything from the budget process with Congress … to the acquisition process that is cumbersome and prevents agile acquisition due to reporting requirements and [the fact that] budgets are allocated so far ahead that we are stuck in time.”

He added that the sheer amount of compartmentalization within the DoD makes it difficult to build consensus among leadership and to get anything done.

Chaillan also said that such difficulties were particularly burdensome in terms of developing cutting-edge technologies, as it was difficult within the DoD to upgrade to yesterday’s technologies, much less tomorrow’s.

He noted that the budgeting process as a whole ultimately is the responsibility of Congress to fix. The process’s knock-on effects throughout the DoD were dangerous nonetheless, he said. Key among them, he said, was the need to allot finances for specific projects many years in advance.

Currently, Pentagon leaders develop a five-year program that will serve as an outline for the scope and funding of their endeavors. This program is then used to inform the branch’s budget request of Congress. Congress then allocates funds for future use, as it dissects the Pentagon’s alleged needs.

The problem, of course, is that military responses to emerging threats and IT development can’t be pre-allocated, meaning that many programs come into existence and end up being unnecessary, while other needed technologies go unfunded.

“[The budget process] isn’t the Pentagon’s fault, but it has toxic ripple effects across the building as the Pentagon is now working the 2024 to 2029 budget,” Chaillan said.

“How could this even work out? No one knows what IT will look like in 2025, let alone 2029.”

As such, he said, current acquisition processes hinder the integration of expert industry experience into the military, effectively preventing the military from expanding its talent pool. This is because the Pentagon cannot effectively train and continuously fund IT workers whose expertise needs to be continuously changing with the technology, as the budget process forces them into long-term, semi-static programs agreed to at times years in advance.

Such statements echo similar remarksmade by Michael Sekora last month. Sekora, who spearheaded Project Socrates, a Reagan-era Defense Intelligence Agency program designed to increase U.S. competitive advantage, lambasted what he referred to as a “finance-planning” model of defense.

In such a system, Sekora said, the government merely allocates funds year by year, in the hope that the funds will somehow be transformed into the technologies that are needed when they are needed.

The CCP, meanwhile, was pursuing a technology-based strategy whereby specific technologies were created and deployed in a whole-of-society effort to address real problems in real time.

“China understands that exploiting technology more effectively than the competition is the foundation of all competitive advantage,” Sekora said.

“Anything else is a guaranteed exercise in futility.”

Talent Retention ‘Worse Than I’ve Ever Seen’

To that end, Chaillan noted that a vital aspect of working in technology-oriented fields is the need to be forever learning, improving, and iterating. Unfortunately, he said, making continuous learning a part of the job is not something that the military bureaucracy allows much of.

“We don’t invest enough in our talent,” Chaillan said. “We must understand that with the pace of IT, the only answer is continuous learning.”

Chaillan said that when he was chief software officer for the Air Force, he would give his team an hour every day to dedicate to learning new concepts. That model isn’t in vogue with the Pentagon, however, which typically approaches IT-related fields from a managerial perspective.

“Usually, learning is seen as a yearly thing or worse,” Chaillan said. “Additionally, the DoD believes in this concept of ‘knowing everything’ where no one is supposed really to become an expert at something, they just learn to manage and they supposedly can manage anything from a [fighter] wing to a maintenance crew to an IT team.”

This managerial approach was negatively affecting IT in the military, which requires a more active and entrepreneurial approach, Chaillan said. Moreover, it encourages the placement of military officers to leadership roles based purely on rank rather than in-field qualifications.

“We are setting up critical infrastructure to fail,” Chaillan wrote in a separate open letter in September that explored his reasons for resigning from the Pentagon.

“We would not put a pilot in the cockpit without extensive flight training; why would we expect someone with no IT experience to be close to successful?”

That problem was compounded, Chaillan said, by a lack of opportunities for IT professionals in the military to actually apply themselves at the jobs they were trained to do.

“Obviously, that doesn’t work with IT,” Chaillan said.

That means that many IT professionals in the military are prevented by bureaucratic processes from further developing professionally, eventually becoming “stale” at their skill set. It’s a problem that Chaillan himself cited as a reason for his own departure from the Pentagon.

Perhaps because of this, many of the companies at the forefront of new technological development simply won’t work with the DoD, Chaillan said.

“Unfortunately, many companies still refuse to work with DoD, which isn’t helping us get access to best-of-breed talent,” Chaillan said. “We also have a very tough time retaining talent right now, particularly in IT. It’s worse than I’ve ever seen.”

Chaillan lamented the fact that chief information officers in the DoD weren’t being fully utilized, and were effectively being treated as lottery tickets whose projects may or may not be picked for funding rather than as drivers of innovation.

“DoD Chief Information Officers are just seen as policy shops instead of actual doers,” Chaillan said. “That would never happen on the commercial side. That must be changed.”

Indeed, in his open letter, Chaillan wrote that the very same happened to him, much to the detriment of U.S. defense needs and equally to the advantage of the CCP. He was underutilized, he said, and spent the majority of his professional time trying to convince others to consider more efficient solutions to well-known problems.

“The DoD should stop pretending they want industry folks to come and help if they are not going to let them do the work,” he wrote. “While we wasted time in bureaucracy, our adversaries moved further ahead.”

‘Four Cents of Real Value on a Dollar’

That mismanagement and the adverse effects it has on military readiness are only the tip of the iceberg, however. By Chaillan’s estimation, the Pentagon is only utilizing 4 percent of its funds on actual solutions.

“Overall, I believe we get four cents of value out of one dollar of taxpayer money spent,” Chaillan said.

“First, probably 60 cents are wasted due to cumbersome acquisition processes and requirements which were made to prevent fraud or conflicts of interest or bad behavior, but really ended up creating a massive bureaucracy which created more waste than it is preventing.

“Second, because we are stuck in time and get requirements that are five to 10 years too old, we effectively buy many things that are obsolete or aren’t a good fit to the current mission and should have been voided but we don’t because we spent years trying to get the contract done.

“That’s probably another 30 cents. Another six cents is wasted by making mistakes, which are fair and common.

“That’s four cents of real value on a dollar. With $750 billion funding, that means $30 billion is actually real tangible value.”

Chaillan was careful to point out that the figure is only his opinion but said that most of his professional acquaintances would agree that the DoD loses at least 60 percent of its funds to such wastage.

Regardless, bureaucratic waste remains widespread, and outdated or otherwise unneeded technologies remain a persistent problem. The fact is that parts of the military, for its trillions of dollars received over the years, simply don’t have adequately functioning technology.

That problem was highlighted in anopen letter to the DoD penned in January by Michael Kanaan, director of operations for the Air Force-MIT Artificial Intelligence Accelerator, a joint AI research endeavor, in which he flogged military leadership about the fact that its IT professionals were working with computers that were decades old.

“Want innovation? You lost literally HUNDREDS OF THOUSANDS of employee hours last year because computers don’t work,” Kanaan, who was Air Force’s first chairman for AI, wrote. “Fix our computers.”

“It’s not a money problem, it’s a priority problem.”

US Approaching ‘The Point of No Return’

Such problems and the waste that causes them are not new, however, nor are they a secret. Indeed, in many instances, such waste is baked into the U.S. defense-industrial complex by excessive congressional oversight.

In 2015, then-Navy Secretary Ray Mabus said that 20 percent of the defense budget was “pure overhead.” Former Secretary of Defense Robert Gates, meanwhile, set that number at closer to 40 percent.

Likewise, another former Navy secretary, John Lehman, said that “roughly half of all uniformed personnel serve on staffs that spend most of their time going to meetings and responding to tasks from the hundreds of offices that have grown like mold throughout the vast Defense Department.”

In 2015, a DoD report was compiled to examine the problem, and found that $125 billion, roughly a quarter of its annual budget at the time, was lost on administrative waste over the course of five years.

The Pentagon ultimately buried the report, classifying its data out of a fear that Congress would cut its budget.

Likewise, accounting firm Ernst and Young found in 2018 that the Defense Logistics Agency, the Pentagon’s main procurement wing, failed to properly document more than $800 million in construction projects.

Perhaps unsurprisingly, the Pentagon also failed all three of its audits, each conducted since 2018, when it was subjected to its first independent and department-wide audit.

In 2020, then-DoD Comptroller Thomas Harker said that the department likely wouldn’t pass an audit until at least 2027.

In sum, the Pentagon is failing to invest in relevant new technologies because its bureaucracy is slowing the investments it does make. Meanwhile, its funding structure and excessive administrative oversight are hemorrhaging most of the funds it receives before the money gets to projects that might be outdated or unnecessary by the time the budget is approved.

According to Chaillan, the United States must compete with China’s superior population by becoming more efficient, more innovative, and more agile. Under the current bureaucratic structure, however, the likelihood of that happening is fast becoming an impossibility, he says.

Even as the CCP invests in AI/ML, autonomous systems, space warfare, and quantum computing, the U.S. military is struggling with a lack of basic, functioning IT equipment. Moreover, Chaillan said, it’s failing to deliver on the tangible products required to win a war.

“The biggest threats to readiness today [are] our lack of access to basic IT capabilities like Edge computing, Edge cloud, proper connectivity, modern devices, and ensuring we can connect all the military domains to get a full picture of our current situation,” Chaillan said.

“More importantly, the lack of investment in AI/ML tangible military outcomes instead of focusing on AI/ML ethics will be what leads us to getting behind to the point of no return if that doesn’t change by December 2022.”

Article link: https://www.theepochtimes.com/pentagons-bureaucratic-waste-ensures-us-loses-ground-to-china-former-chief-software-officer_4271917.html

Andrew Thornebrooke is a reporter for The Epoch Times covering China-related issues with a focus on defense, military affairs, and national security. He holds a master’s in military history from Norwich University

Andrew Milburn and Shawna Sinnott| 02.12.22

In Episode 46 of the Irregular Warfare Podcast, we discuss a fundamental change that has occurred in the nature of war—and what this means for the United States and its allies.

Our guests explain why this change renders the American way of war obsolete and turns assumptions about US military dominance on their heads. They discuss how China, our most capable potential adversary, has used technology to enhance the primacy of its kill chain, while the United States pursues a method of war that is platform-centric and dangerously outdated. They predict that within a few years, if the United States does not adopt a radically different approach to warfighting it will find itself completely outmatched by China militarily—with devastating consequences for America’s place in the world and for the global norms which we now take for granted.

General David Berger is the thirty-eighth commandant of the Marine Corps. An infantry officer by background, he has served in a wide variety of command and staff billets over the course of his forty-one-year career. In his Commandant’s Planning Guidance, he has set the Marine Corps on a course to divest legacy platforms such as tanks and artillery while pursuing capabilities such as long-range sensing and precision fires that will—he believes—better prepare it for future conflict.

Christian Brose is a senior fellow at the Carnegie Endowment for International Peace and the author of The Kill Chain: Defending America in the Future of High-Tech Warfare. From 2014 to 2018, he was the staff director of the Senate Armed Services Committee. He led a team of professional staff who supported Chairman John McCain and other majority committee members in overseeing the national defense budget, programs, and policies across the Department of Defense.

Together they discuss what needs to be done to enable the United States to maintain parity with China. That is, argues Brose, the best outcome that we can hope for at this stage in the game. General Berger, on the other hand, is more optimistic. He believes that the joint force—and the Marine Corps in particular—recognizes the threat and will move fast enough to find solutions and maintain US military dominance. Both agree, however, that this will not be easy, and they conclude with some valuable advice for both policymakers and practitioners alike.

The hosts for this episode are Andy Milburn and Shawna Sinnott. Please contact them with any questions about this episode or the Irregular Warfare Podcast.

The Irregular Warfare Podcast is a product of the Irregular Warfare Initiative, a collaboration between the Modern War Institute at West Point and Princeton University’s Empirical Studies of Conflict Project—dedicated to bridging the gap between scholars and practitioners to support the community of irregular warfare professionals.

Article link; https://mwi.usma.edu/the-kill-chain-why-america-faces-the-prospect-of-defeat/

You can listen to the full episode below, and you can find it and subscribe on Apple Podcasts, Stitcher, Spotify, TuneIn, or your favorite podcast app. And be sure to follow the podcast on Twitter!

Podcast > https://www.stitcher.com/show/irregular-warfare-podcast/episode/the-kill-chain-why-america-faces-the-prospect-of-defeat-90425286

El Centro de Bienestar está abierto de 9 a. m. a 5 p. m., todos los miércoles. Para hacer una cita, llame al 610-872-2011.

The Wellness Center at St. Paul’s is open 9 a.m.-5 p.m., every Wednesday. The free clinic, staffed with licensed health care professionals from Widener University, provides services for men, women and children, with or without insurance. To make an appointment, call 610-872-2011. #wellnesscenter #healthclinic #wellbeing #WidenerUniversity #chestereastside

By BRANDI VINCENTFEBRUARY 9, 2022

The solution embraces zero trust principles, officials said

After exploring multiple commercial prototypes, the Defense Innovation Unit is rolling out Google Cloud’s Secure Cloud Management solution, or SCM, across its entire organization.

Other Defense Department agencies can procure the offering through Other Transaction Authority agreements, according to a press release published by Google on Tuesday.

“In today’s new cybersecurity paradigm, it’s critical that government agencies see the benefits of adopting a zero trust security strategy and have the option of selecting more modern, cloud-native solutions that meet their unique needs,” Google Cloud Vice President, North America Public Sector, Lynn Martin wrote in the announcement.

Google Cloud developed SCM in collaboration with Palo Alto Networks. 

The solution is considered a container-based offering that enables secure access to and management of hybrid cloud and multi-cloud applications, as well as ongoing monitoring.

This contract award follows a project in which DIU deployed three different year-long prototypes—each made individually by either Google, Zscaler, or McAfee Public Sector—to supply software-as-a-service options seamlessly over the internet. 

SCM “embraces” zero trust principles and aligns with policies from President Joe Biden’s administration on implementing that modern approach, officials wrote in the release. 

A third-party assessment organization evaluated this tool, they added, based on recommendations from the Defense Information Systems Agency.

To work with the Pentagon, cloud service providers have to show that they can meet specific security requirements, depending on the sensitivity of the data they will host. Lower “impact levels” handle data cleared for public release, and impact level six, or IL6, encompasses classified national security information.

“Google Cloud is FedRAMP High certified, has an IL2 PA globally, recently received an IL4 PA and is working with DISA for IL5 and IL6,” a Google spokesperson told Nextgov in an email on Wednesday. “Expanding our list of compliance certifications is a critical part of our mission and we are actively working towards higher approval levels.”

Google is one of several major technology companies preparing a bid for the Defense Department’s multibillion-dollar Joint Warfighting Cloud Capability, or JWCC contract.

Article link: https://www.nextgov.com/it-modernization/2022/02/dods-commercial-it-innovation-hub-deploy-google-secure-cloud-offering/361797/

By Courtney Albon

Feb 7, 04:33 PM

WASHINGTON — The Pentagon’s new software modernization strategy calls for establishing an enterprise-level software factory ecosystem to make the tools and applications used by its development hubs a more regular part of doing business.

The document, released late last week, says the 29 software factories that exist today across the military services have made significant progress, but the Department of Defense needs to better take advantage of that innovation. Danielle Metz, deputy chief information officer for the information enterprise, told reporters on Monday the goal is to harness the success of those factories and “inculcate that into the DNA of the department.”

Today’s software factories serve as centralized teams that provide software development services to various program offices. Well-known hubs include the Air Force’s Kessel Run, the Navy’s Overmatch Software Armory and the Army’s Coding Resources and Transformation Ecosystem.

Metz and Pentagon Chief Software Officer Jason Weiss told reporters the department doesn’t necessarily want to make changes to how the factories operate, but instead wants to hear from those organizations about what policy changes and standardization might be most helpful.

Weiss said the department expects to gain efficiencies and cost savings by being more strategic about how the factories operate and ensuring any redundancies aren’t inhibiting economies of scale.

“If we can achieve that, then that allows the software factory ecosystem to continue to grow, but to operate with higher degrees of scale and precision without having to start from scratch at every point,” he said.

Beyond establishing an enterprise-wide development ecosystem, the strategy identifies two other goals: accelerating the DoD enterprise cloud environment and transforming processes to enable resilience and speed.

As part of the cloud acceleration focus, the strategy calls for an “innovative portfolio of cloud contracts” to offer better access to cloud services. It also emphasizes the need to secure data in the cloud and improve infrastructure outside the continental United States to ensure those installations can take advantage of cloud capabilities.

To improve its software development and acquisition processes, the department must reevaluate its policies and guidance to make sure they’re not overly restrictive and continue to support flexibility in the way it acquires and funds software, the strategy says.

A memo accompanying the strategy, signed by Deputy Secretary of Defense Kathleen Hicks, says the department will develop an implementation plan over the next six months. A newly formed Software Modernization Senior Steering Group will coordinate and prioritize efforts under the strategy and will develop a yearly action plan. The group will also create a software capability portfolio to inform budget decisions and make sure efforts are integrated across DoD.

Article link: https://www.c4isrnet.com/battlefield-tech/it-networks/2022/02/07/new-pentagon-strategy-would-elevate-software-factories/

About Courtney Albon

Courtney Albon is C4ISRNET’s space and emerging technology reporter. She previously covered the U.S. Air Force and U.S. Space Force for Inside Defense.

The Defense Department released a broad plan to expand and ensure its technological edge on the shifting global conflict stage—equipped with a list of more than a dozen technologies it is prioritizing in the near term—via a six-page memorandum published on Thursday.

Penned by Defense Undersecretary for Research and Engineering and DOD Chief Technology Officer Heidi Shyu, the USD(R&E) Technology Vision for an Era of Competitionpreviews the impending National Defense Science and Technology Strategy and its development. Shyu’s office will also steer the making of that future-facing blueprint.

President Joe Biden’s administration is placing a sharp focus on strategic competition, particularly with Russia and China, as it crafts the latest National Defense Strategy that’s expected to be released early this year.

The Defense Department released a broad plan to expand and ensure its technological edge on the shifting global conflict stage—equipped with a list of more than a dozen technologies it is prioritizing in the near term—via a six-page memorandum published on Thursday.

President Joe Biden’s administration is placing a sharp focus on strategic competition, particularly with Russia and China, as it crafts the latest National Defense Strategy that’s expected to be released early this year.

A DOD spokesperson told Nextgov on Thursday that the S&T strategy’s release will depend on that of the National Defense Strategy, as the latter is considered the “guiding document.”

In the new memo, Shyu wrote that the United States’ “strategic competitors” have greater access to ultramodern commercial technologies “than ever before,” which can be used to disrupt America.

“The challenges facing our country are both diverse and complex, ranging from sophisticated cyber-attacks to supply chain risks, and from defending against hypersonic missiles to responding to biological threats,” she wrote, later adding that it’s “imperative for the department to nurture early research and discover new scientific breakthroughs to prevent technological surprise.”

Three pillars that will “anchor” the Pentagon’s forthcoming technology strategy are detailed in this memo. They are listed as:

1. Mission Focus: Leverage the United States’ incredible technology innovation potential to solve the department’s tough operational, engineering and mission-focused challenges. 
2. Foundation Building: Set the foundation to attract and build a strong, talented future technical workforce that works in modernized laboratories and test facilities.
3. Succeed through Teamwork: Maximize asymmetric advantages by partnering with the larger innovation ecosystem, from industry to universities and to laboratories, allies and partners.

The undersecretary further emphasized that this “era of strategic competition demands collective cooperation.” Among others, DOD will need to work with the defense industrial base, academia, startups, international partners and “even with our competitors,” she wrote, to confront the challenges of this century.

Also in the memo are 14 “critical technology areas,” that DOD considers “vital to maintaining” U.S. national security. They are spread across three categories. The list will be updated as capabilities and the defense strategies evolve, but for now, it includes:

• Seed areas of emerging opportunity: biotechnology, quantum science, future generation wireless tech—or FutureG—and advanced materials;
• Effective adoption areas: trusted artificial intelligence and autonomy, integrated network system-of-systems, microelectronics, space technology, renewable generation and storage, advanced computing and software, and human-machine interfaces;
• Defense-specific areas: directed energy weapons and systems, hypersonics, and integrated sensing and cyber.

“Successful competition requires imagining our military capability as an ever-evolving collective, not a static inventory of weapons in development or sustainment,” Shyu wrote. “In many cases, effective competition benefits from sidestepping symmetric arms races and instead comes from the creative application of new concepts with emerging science and technology.”

Article link: https://www.nextgov.com/emerging-tech/2022/02/defense-department-previews-new-future-facing-technology-aims/361578/

Written by John Hewitt Jones
Feb 1, 2022 | FEDSCOOP

The Department of Veterans Affairs failed to ensure that data transferred during the rollout of its new electronic health record (EHR) modernization platform met clinicians’ needs, according to a new audit by the Government Accountability Office.

In a wide-ranging report published Tuesday, the watchdog found that the department failed to sufficiently monitor the accessibility, accuracy and appropriateness of clinical information as it was transferred in segments from one system to another.

GAO recommended that the department establish performance measures for migrated data and that it use a stakeholder register.

“Although VA performed data testing activities identified in its plans, the department did not ensure that the quality of data migrated to the new EHR system sufficiently met clinicians’ quality needs,” GAO said in the report. In some interviews conducted by the watchdog, clinicians reported being unable to access patient information such as allergies, medications and immunizations, and also reported data errors.

The concerns were raised in relation to a staging environment used as data was transferred from the VA’s National Data Center in Austin, Texas, to a data center operated by contractor Cerner in Kansas City, Missouri. GAO’s performance audit was conducted over the period August 2019 to February 2022.

A greater-than-required volume of certain patient data, such as medication data, was also selected for initial migration, according to the watchdog. It found also that while VA implemented a feedback system to address concerns, it did not use a stakeholder register to help identify and engage all relevant stakeholders for reporting continuity.

“A stakeholder register is intended to help identify and engage all relevant stakeholders. Until VA uses such a tool, the department risks overlooking EHRM stakeholder needs for reporting on patient care, operations, and research functions,” the watchdog said.

The Office of Management and Budget’s Federal Data Strategy highlights the importance of validating data quality, including their accessibility, accuracy and appropriateness.

The new findings come after sustained criticism from lawmakers late last year following the department’s decision to push ahead with the rollout of the EHR platform at a new location despite safety concerns from frontline staff.

Last month, the VA announced a further delay to the rollout of the program, citing surging COVID-19 cases at its medical network in central Ohio. The system will now go live at the location April 30 instead of the previously set date of March 5.

Cerner’s Millennium platform and Cerner HealtheIntent cloud platform form the backbone of VA’s health records modernization strategy, which relies on transferring patient data off the VA’s legacy Veterans Health Information Systems and Technology Architecture (VistA).

In a statement, VA said that it concurred with the recommendations in GAO’s report: “The Electronic Health Record Modernization (EHRM) Integration Office will establish and use performance measures and goals, aligned with and integrated into the VA Data Strategy, to ensure the quality of migrated data meets stakeholder needs for accessibility, accuracy and appropriateness prior to future system deployments.

“This aspect of EHRM will meet enterprise data quality and reliability standards. The EHRM Integration Office will also use a stakeholder register to improve the identification and engagement of all relevant EHRM stakeholders and address their reporting needs,” the agency added.

In a statement, general manager of Cerner Government Services Brian Sandager said: “Supporting the VA in its efforts to provide veterans with safe, effective, holistic care is our top priority.” He added: “We are committed to working with our VA partners to quickly identify and aggressively address any concerns, as they implement a new electronic health record system that will give veterans and their providers a single record to support a lifetime of seamless care.”

Article link: https://www.fedscoop.com/va-failed-to-ensure-data-quality-during-initial-ehr-rollout-gao-finds/

Editor’s note: This story was updated to include additional comment from VA and Cerner.

by Doug Sundheim April 23, 2020

The writer George Saunders has a fitting analogy for the current Covid-19 moment: We’ve slipped on ice but haven’t hit the pavement yet. We’re caught in a suspended state between losing control and feeling the full impact.

The comparison points to a paradoxical tension that leaders must manage: providing direction, guidance, and reassurance while acknowledging that the path ahead isn’t clear. Doing one thing without the other doesn’t work. Both are needed to help people find the clarity and strength to move forward.

Balancing this tension requires leaders to lead with humanity and do a few important things.

Put People First 

Hard-charging cost savings and profit motives that may have previously served an organization well could backfire in the current environment. In a recent survey by the public relations firm Edelman, 71% of respondents said they would lose trust in a brand forever if they believed it was putting profit over people. The reaction to companies perceived as having done so has been punishing and swift:

• Within 24 hours of cutting staff members’ pay, the owners of the NBA’s Philadelphia 76ers admitted they had a mistake, apologized, and reversed course, largely avoiding a backlash. The owners of the NHL’s Boston Bruins and their home arena, TD Garden, were slower to react and got brutalized in the media as a result.
• When the food delivery service GrubHub rolled out a discount for customers ordering online, supposedly to support restaurants struggling in the pandemic, it forced restaurants to bear the discount’s brunt, drawing ire from restaurants and customers and sparking calls for a boycott.

Other organizations are putting people first. The Las Vegas Sands has said it will pay its nearly 10,000 employees as if they were still working even though its properties have been closed. The Dallas Mavericks has kept on all its hourly workers.

And consider VillageMD, which partners with and employs some 2,700 physicians across the United States. I spoke with CEO Tim Barry last week about his company’s strategy. With patient volume in many medical practices down by 50% to 75% and providers laying off and furloughing clinical and nonclinical staff, VillageMD is finding creative ways to keep people on. It’s  scaling back office visits, now reserved for the most medically needy, and ramping up telehealth services.

“We are resisting cuts, because it’s the right thing to do for both patients and staff,” Barry told me. “Instead of laying off our medical assistants, we have asked them to stay in virtual contact with our sicker patients. The patients love the extra attention during this confusing and often lonely time, and our staff is thrilled to continue engaging with them. While we can’t guarantee no layoffs, we are being transparent about the situation and our desire to avoid them. And we are asking people to be flexible in terms of what is being asked of them.”

Be Up-Front and Vulnerable

Everyone is having bad moments, bad days, and bad weeks. It’s OK to let the struggles show. Several years ago I wrote about the idea that good leaders get emotional. That’s never been more true.

After seeing Marriott’s revenue fall by nearly 75% in most markets because of Covid-19, CEO Arne Sorenson wanted to deliver a video message to employees. His team advised against it because of his appearance: He had been undergoing treatment for pancreatic cancer, and chemotherapy had left him bald. Sorenson made the video nonetheless. In it he announced that he and the company’s chairman would forgo their salaries in 2020 and that the executive team’s compensation would be halved. He choked up at the end, while talking about supporting Marriott associates around the world. The video has inspired other leaders to give up their salaries too.

Openness and vulnerability were also exemplified by Dan Price, the CEO of the credit card processor Gravity Payments, whose monthly revenue had been cut in half by the pandemic. He calculated that the company would be bankrupt in several months. Wanting to avoid layoffs but facing a grim financial reality, he decided to share the situation with his staffand get people’s input about how to proceed. Over the course of four days he and his COO held 40 hours of meetings with small groups of employees. “We just put all our cards on the table,” Price says. “And we listened.”

Following the meetings, company leaders decided to reduce salaries rather than lay people off, but their plan had an important twist. Instead of cutting everyone’s pay by a certain percentage across the board, they asked each employee to say privately how much he or she could sacrifice. The strategy worked because Price had built a strong culture of trust. ”CEOs: please, consider talking with your employees before laying them off,” he tweeted. ”We lost half our $4M monthly revenue & had 4-6 months until bankruptcy. When we told employees this, they volunteered pay cuts that will get us through 8-12 months, with no layoffs.”

Support and Connect

The pandemic is having a vastly different personal impact from previous crises. People are getting sick; some are dying. Amid our existential anxiety, we’re doing our best to carry on. We’re working from home, if we’re lucky; we may be unemployed, or we may be out on the front lines. Our children are trying to learn online and are missing their friends. We’re worried about our elderly loved ones. We’re worried about rent, mortgages, and the other day-to-day needs we took for granted just weeks ago. Compassion and opportunities for sustained connection are critical.

For leaders, this means, at a minimum, slowing down, being flexible, and giving employees leeway to deal with these new challenges. It also means an opportunity to connect more deeply.

Last week I spoke with the U.S. CEO of a global professional services firm about the importance of making time for personal connections. “We’re learning a lot about what works and what doesn’t in connecting the organization virtually,” he said. “One of the most valuable lessons is the importance of making more room for informal, face-to-face, unstructured time. In a culture that is usually all business, we’ve been hitting the pause button to just listen and support one another.”

He shared an example of a town hall call that went over by an hour as colleagues in some of the hardest-hit areas of the world shared their stories. “As leaders, we recognized that the need to hear and support one another was more important than the transactional needs at that moment. That simple insight can be easily missed among a bunch of Type-A professionals. But it’s crucial. The former supports the latter over the long term.”

Connecting on a personal level has also been a priority for Neil Sprackling, president of U.S. Life & Health at the reinsurer Swiss Re. “I start and finish every employee and client interaction on a personal note,” he says. “We tell stories, and I ask if they need any specific support. It seems small, but taking the time to consciously do this has been tremendously helpful in strengthening relationships and maintaining our sanity.”

That personal approach has been extended to group gatherings. When one of Sprackling’s senior direct reports retired last week after 40 years with Swiss Re, his team organized a surprise virtual farewell. “The retiree thought she was dialing into a call with her direct reports.Then over 30 colleagues and I joined a Skype video chat. We made time for each person to share a tribute. It was a very poignant moment. Kleenex all around.”

It could be argued that the suggestions outlined above are just good leadership, no matter what the circumstances. That may be true, but it misses an important point: Understanding good leadership and practicing it are two different things, especially in the face of uncertainty and one’s own anxiety.

In the weeks and months ahead, leaders need to move beyond themselves and stand in other people’s shoes. Endure challenges on others’ behalf. Be open and vulnerable. Experiment with ways of offering communication and support. Trust that caring and open-hearted leadership will not only pay off now but also reap rewards well into the future.

Article link: https://hbr-org.cdn.ampproject.org/c/s/hbr.org/amp/2020/04/the-best-leaders-meet-a-crisis-with-humanity

Doug Sundheim is a leadership and strategy consultant. His latest book is Taking Smart Risks: How Sharp Leaders Win When Stakes are High. Follow Doug on Twitter and LinkedIn and find out more about his services at www.sundheimgroup.com.