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VHA Intersectionality Overview:
Strategic Environmental Assessment
&
The Blueprint for Excellence
Executive Summary:
The purpose of this paper is to illustrate the various instances in which external trends
expressed within the Strategic Environmental Assessment (SEA) might either assist or inhibit the
VHA’s Blueprint for Excellence (BFE). The SEA referenced within this paper was produced
May 2015. For each environmental trend brought forth by the SEA, their relation to the ten
strategies and four themes found within the BFE is assessed. Goals and intentions for each
strategy and theme, in relation to environmental trends, are assessed.
The SEA provides an overview of 6 environmental trends. These trends either involve
changes in how people as individuals conduct themselves, changes in socialization, and changes
in technology. The changes occurring outside the VA are as follows: Individual
Empowerment; Exploration, Development, and Utilization of Resources; Applied
Technology; Increasing Pace of Innovation; Societal Evolution; Power, Influence, and
Wealth Dynamics.1 BFE provides us with four themes: Improving Performance, Promote a
Positive Culture of Service, Advance Health Care Innovation for Veterans and the County,
Increase Operational Effectiveness and Accountability.2 The ten Blueprint for Excellence
strategies under the four themes are comprehensive and will be referenced throughout the
document when necessary.
Findings:
The trend of Individual Empowerment promotes fewer levels of bureaucracy, increases
in freelancing, increased crowdsourcing and increases in the usage of mobile platforms.2
Elements within this trend could complement two of the ten BFE strategies. Increases in
freelancing and crowdsourcing may aid Strategy 8, promoting and cultivating public-private
partnerships.2 Freelancers and crowdsourcing may facilitate the VHA’s pursuit of legitimate
community partners to fill in gaps within service delivery. The trend of Individual
Empowerment is also supported by Strategy 6, personalized, proactive, and patient-driven health
care.2 Personalized, patient-driven solutions for Veterans integrate the patient’s needs and values
in regards to their well-being.2
The trend involving the innovation of mobile platforms complements the BFE Strategy
3, leveraging information technology and data collection.2 By creating new methods of data
collection, the VHA might be able to implement preventive health care services for Veterans.
Through this strategy, VHA health care solutions for Veterans may become anticipatory of their
1 Strategic Environmental Assessment
2 BlueprintFor Excellence

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future health care needs. Those who might benefit most from the shift are the Veterans
experiencing greater social and economic obstacles to health.
There have been instances when Veterans using VA services would encounter difficulties
navigating directories and booking appointments. Veterans reported that responses to their
request by the VHA can be confusing and time consuming. Veterans want easy self-service
transactions.3 These initial first impressions could leave a long-lasting negative impression for
Veterans using VA services for the first time.3 Equipping Veterans with personalized
experiences through mobile applications may improve feedback and empower users with more
control of their VHA benefits.
Environmental trends that focus on how we explore, develop, and utilize resources also
have impact on our BFE. New third-party sources for our inputs and service outputs will
increase in availability. Strategy 8 promotes the utilization of Veteran care community providers
to ensure health care needs are met in an evolving system.1 This includes partnering with local
communities and organizations. Our goal of a sufficient community presence could be
facilitated through this trend.
As third party providers grow in influence and frequency, the VHA will gain the ability
to improve service delivery through collaboration. Coinciding with BFE Strategy 8, the
increased frequency of third party service organizations will broaden the scope of accessibility
for Veterans. Through public-private partnerships, the VHA will be able to facilitate a fully
integrated health service network. And the coordination between the VHA and community
Veteran care providers will foster diverse solutions including the expansion of non-capital
agreements, reduced service duplication, and leveraging existing resources.2 VA Integrated
Service Networks (VISNs) will provide the framework needed to ensure facilities, furnishings,
and networks are shared efficiently between the VA and Veteran care in the community health
service providers.2
An increase in technological advancement is a trend that may address three of the
strategies within the BFE. Not only does this trend in innovation facilitate improvements in
performance, but also compliments portions of the Institute of Medicine’s (IOM) “Six Aims for
High Performance Healthcare”. The IOM’s model for high performance health care functions as
a key reference in BFE Strategy 2, Veteran-centered health care comparable to private-sector
quality. Increases in innovation may reduce delays in customer service feedback and improve
efficiency, which are two components within IOM’s requirements for high performance
healthcare.2 Consumers and producers will have access to real-time information. The
availability of real-time information will drastically reduce internal processes before output.
Strategy 3, leveraging information technology of patients enrolled, may utilize improvements in
technology to enhance data capture of patients. Self-monitoring devices will provide instant,
comprehensive information on patient health. Feedback on the health of Veterans may improve
through the usage of these technologies. More proactive patient health tracking may manifest

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through the usage of these technologies. Proactive information gathering compliments Strategy
1, which promotes practices focused on anticipating patient health.2
The use of applied technologies will improve the VHA’s access for Veterans, regardless
of their geographic location. Advancements in applied technology create new avenues for
communication and service delivery. Virtual platforms will allow VA services to be assessable
for Veterans living in rural and remote areas. Our organization’s mission to promote more
Veteran-centered practices is supported through the mitigation of geographical barriers in
service.
The use of virtual platforms will expand VA’s strategy of more Veteran-centered and
personalized service solutions for Veterans living in remote areas. Veterans like Heather
McDonough, require non-traditional pathways for VA services. Some Veterans have chosen
rural areas for more peaceful, self-sufficient living than that offered by cities. For Heather, rural
living has given her the opportunity to address military sexual trauma (MST)3. Allowing her the
opportunity to use virtual platforms and accommodate her geographical circumstance promotes
the VA’s Veteran-centered initiative. Though Heather may not be in close proximity with a
VAMC, advances in technology, including virtual platforms and other mobile devices, will
deliver health care without the penalty. Strategy 6’s transformational actions, including the
implementation of mobile applications and personalized health plans (PHP), may improve the
delivery of services from the VA to Veterans matching Heather’s requirements.2
Another impactful environmental trend referenced in the SEA is referred to as societal
evolution. Specifically, the trend of Societal Evolution focuses on advancement in social media
and network technology.1 Social media platforms may function as a mechanism for both product
promotion and consumer feedback. Proactive communication with Veterans through social
media will help facilitate accountability and transparency for the VA, which improves
organizational integrity. Promotional information distributed by the VA would be limited to
non-confidential materials. Corresponding to Theme 3, innovations in social media could
become a catalyst for the VA to improve feedback and communication with Veterans.2 Investing
in innovative pathways for Veteran outreach may solve issues with current communication
barriers. As addressed in Theme 4, communication and accountability regarding performance for
Veterans will be proactive.2 The VHA’s renewed focus in ethical leadership may promote
internal measures to address accountability.
The increased integration of social media platforms for advertising and consumer
feedback may encounter security concerns. Increased usage of social media platforms that are
open to the public, and unrestricted in access, may increase the probability of data breaches. To
mitigate this potential concern, BFE Strategy 10, organizational modernization, could be
3 Voices of Veterans

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implemented.2 An up-to-date, data collection system would insulate the VA from possible
security breaches.
Our organization’s ability to communicate services efficiently and clearly has become a
growing concern for those most impacted by the VA’s services, Veterans. Timothy Washington,
a Veteran serving in the National Guard, was under the impression that the VA exclusively
focused on the needs of elder servicemen. Timothy was not made aware of the wide variety of
benefits at his disposal, supplied by the Veteran’s Benefit Administration.3 To prevent other
Veteran’s from potentially “falling through the cracks”, the VA must continue communicating
services through diverse social media platforms.
The trend with the highest potential for negatively impacting the VA involves changes in
power, influence, and wealth dynamics. The SEA highlights a negative trend involving trust
in institutions, which is leading to an increase in fiscal uncertainty.1 Though the SEA does not
elaborate on specific institutions and their favorability, the VA must be cognizant of this trend.
Increasing government divestment of funds from public institutions to the private-sector may
lead to budgetary constraints, reducing the VA’s ability to execute its mission. Strategy 2
corresponds with this trend by delivering high-quality health care consistent with private sector
standards to maintain Veteran trust, and reinforces the importance of cultivating public private
partnerships.2
Conclusion:
Many of the trends presented by the SEA have internal and external implications. If the
VA is not proactive with addressing changing conditions, the organization will continue to fall
behind. The most impactful trend within this paper is the changes in technology. Innovations in
technology are the primary drivers in the trends referenced. In order for the VA to improve its
service delivery to Veterans, it must become more receptive to technological advancements.
Advancements in technology may affect our internal and external efficiency and effectiveness in
the future. Internal processes and technologies including data management, communications
platforms, and data security affect the organization’s integrity. Outreach to Veterans and
Veteran community organizations rely on the incorporation of the latest social media platforms.
The VHA’s delivery of effective and efficient health care to Veterans relies heavily on the
incorporation the latest strategies working in tandem with the latest technologies.