The Gears of Government award-winning VHA Innovation Ecosystem (VHA IE) works to support, develop, and organize VHA’s innovation efforts in a quest to provide the best care for the Veterans we serve. Through portfolios like VHA Diffusion of Excellence and VHA Innovators Network, VHA IE has cultivated ideas and innovations from frontline employees across the nation’s largest health care system.

While VHA IE supports hundreds of innovative practices, four of them were honored this year as Gears of Government Award winners. These programs have had a massive impact on the way health care for Veterans, and all of America, is being delivered.

“It is incredible to work alongside the talented front-line employees who are tackling the challenges Veterans and VA employees face,” said Allison Amrhein, Director of Operations for the VHA Innovators Network, a portfolio of VHA IE. “We’re excited to be recognized for the work we’re doing to help Veterans.”

Beth Ripley and the VHA 3D Printing Network

Beth Ripley has changed health care for Veterans. By helping establish the VHA 3D Printing Network the Senior Innovation Fellow, Radiologist and Chair of the VHA 3D Printing Advisory Committee has become a national thought leader and innovator in 3D Printing. Her vision to incorporate this technology into VHA with the goal of changing the way health care providers and patients understand and treat disease has resulted in numerous innovations that have impacted the lives of thousands of Veterans. To date the VHA 3D Printing Network has delivered personalized care to 1,000 Veterans through 3D printed pre-surgical planning models, assistive technology devices, orthotics, prosthetics and more. With the number of VHA medical facilities with 3D printing capabilities at 30 and growing, this technology is set to impact all 9 million Veterans that VA serves.

Emergence Delirium: Maintaining Veteran and Employee Safety

Local crisis management and anesthesia experts at VA Pittsburgh Healthcare System designed Emergence Delirium: Maintaining Veteran and Employee Safety for staff working in areas that use sedation.

Emergence Delirium is a post-anesthetic phenomenon that occurs immediately after emergence from general anesthesia. It’s characterized by agitation, confusion and violent behavior. The three-part training is designed to provide the knowledge required for staff to identify Veterans most at risk for emergence delirium and the skills needed to prevent the dangerous behaviors that may result. The team has increased safety and reduced injuries in both Veterans and staff, with their training program now being mandatory.


VIONE has changed the way VA handles prescriptions by implementing a simple and user-friendly medication management methodology. It was developed by Dr. Saraswathy Battar, Associate Chief of Staff for Geriatrics and Extended Care Services at Central Arkansas Veterans Healthcare System, who saw a demand for deprescribing unneeded prescriptions in her facility. Dr. Battar worked through VHA IE to further spread her work, ensuring Veterans only take the medications they need. So far, it has successfully impacted the lives of over 77,000 Veterans by deprescribing 168,000 medications and yielding more than $5.8 million in annualized cost avoidance.


4-Sight, developed and implemented by a team from VISN 22, the Desert Pacific Healthcare Network, has made the process of getting eyeglasses for Veterans faster and more accurate. It also reduces costs for VA by automating an outdated system.

The practice was implemented at multiple sites through VHA Diffusion of Excellence and is now successfully established at 37 facilities and rolling out nationwide. 4-Sight expedited eyeglass delivery for more than 390,000 Veterans. It improves productivity so much that it allows for four full-time employees within the prosthetics department to focus their efforts on complex prosthetic limb orders rather than focus on tedious eyeglass ordering.

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Published on Apr. 29, 2020

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  1. Jo Ann Jones May 7, 2020 at 1:03 am

    We have a new VA center in my town and I love it! I can see my primary care doctor, get lab work done, take an x-ray, attend a group, and fill my RX’s all in the same day and in the same building. The staff are always respectful and attentive. After years of going all over the county to one specialist after another with none of them able to coordinate with each other, my VA Center is a blessing! My level of care is excellent, and I thank God everyday for it.

  2. Giles Cooper April 30, 2020 at 8:28 pm

    Been going to VA since 1973.WW2 vets told us Nam vets “You boys weren’t in a real war”. Nope,we were treated like pos.Gone from bad to worse. I’m glad these young vets are getting treated good. They deserve it.Please make sure the next generation of vets are treated fairly. Treat all veterans the same.Don’t unjustly treat us different. Old Soldier

  3. Robert Imel April 30, 2020 at 5:17 pm

    I would like to ask . To the people who post comments against VA health care system. Have you ever received your care from the private sector.? I am a DAV just turned 71. In 1970 I was discharged from the Army. Went to work the private sector. Health insurance was provided by my employer. When I was getting ready to plan for retirement. I was told should look into the VA health care system. My father a WW2 DAV told me “If I couldn’t get insurance just have your wife drop you off at VA”. Well about 10 years ago thought I would see if this was true. Now in mind I can and do still keep my private care Doctor my insurance is through a national pension plan I keep only for my wife. So I can receive care at either no out of pocket cost. I only keep my private care Doctor because my drugs are free for a 90 day mail order . VA $8.00/ 30days.
    Think about this guy’s every time we go for a clinic visit with our Doctor we go to blood draw first. Not AFTER so the doctor can discuss results as we meet.
    Not get a call 2-14 days later from someone who you don’t know and can’t explain . I could keep going on.
    Private sector doesn’t “do hearing aids”. I wear contacts. Best private sector ever got me to was 20/40. VA though Choice 20/25. and at no cost . In closing I still have the choice for private care and I will Always go to my VA for Care. As one of my pastor’s saying I will Always love you even with all your “warts dimples and pimples”

  4. Cheri Connelly April 30, 2020 at 1:18 pm

    I have had MANY issues with the VA system, being tossed here and there. Since moving from the St Mary’s VA to The Richmond VA (McGuire), my health has deteriorated so bad where I am bedridden 97% of the time. My medications were hijacked, the mental health facility a joke! (They give you 10 visits then group) WTH? While at St. Mary’s. I was seeing an Amazing Dr. once a week for almost 5 years. I suffered a lot with PTSD and I require one one therapy, was finally making progress, then forced to move. Group, not an option! Then my back issues…I have been here almost 2 years and have yet to have that addressed hence the bedridden part. My back is out, AGAIN. I am 100% and alone! Then I had to get glasses, at their eye clinic cost me just shy of $200 and they have messed up the script 3 times, by the way I got the new script, still wrong. They have all these so called programs, half the time they cancel or better yet don’t show up. I am so over it! This is NOT how you treat Veterans, seriously, how many times must we scream it?!? Nothing changes just repackaged!

  5. Gary Fiffe April 30, 2020 at 10:43 am

    If the va is so great how come l have had 6 appts. Reschuled and the local clinic is fully staffed but the are only seeing limited patients this is self promotion at its worst. On 18 years going to the Va l have never complained, l love the Va but they need to be truthful yo the American people who pay their bills.

  6. Warren April 30, 2020 at 9:23 am

    I wasted a lot of time, suffered a lot of agony, learned a lot, and lost over $200 on that debacle! My VA hearing aids helve become are inoperative and there are no audiologists left on my island. No one is addressing that problem.
    but I needed an accurate, precise prescription. Of course that didn’t happen and the aggravation and poor customer service became a battle.

    • Patrick McDonald May 6, 2020 at 8:53 pm

      Request them to outsource you to a civilian audiologist

  7. GJ Gibson April 30, 2020 at 8:32 am

    Mr. AIRMAN. You so are totally correct! I thought that I was the only one that felt like you do. Totally on point. End of story!

    • Cheri Connelly April 30, 2020 at 1:22 pm

      I AGREE!!!

  8. Jon Henderson April 30, 2020 at 7:32 am

    The VA Health care system has become too compliated. Propelled by innumerable career-building, specialist bureaucrats, inventing a plethora of new ‘programs’ osrensibly geared to streamlining old care delivery procedures (which had been working), improving veteran care, and lest we forget, Saving Money. The fact is that as a enrolled veteran receipent, I have become completely flummoxed by the abstruce information, elegibility conditions and care limitations imposed by any of these innovatios that I have seen to date. My eyeglasses provided directly by VA, fall off my face. Following an accident the same day as my Tri-West optometrist appointment, urgently needed eye medication was prescribed by the optometrist and filled locally. Rimbursement was denied because he was not recognised as an urgency provider under the faltering emergence of the Mission Act – I waisted a lot of time, suffered a lot of agony, learned a lot, and lost over $200 on that debacle! My VA hearing aids heve becomeare inoperative and there are no audiorogists left on my island. No one is addressing that problem. It wa that I FLY to another city to see a qualifieed practiconer; highly impractical since I am only wheel-chair-mobile, and non-urgent, and in the midst of COVD-19 resrictions. Additionally, I now need to see a dermatologist. None are availeble here. Same story, but with a suggestion of online tele-video exanmination for which I am not equipped in any way. BUT, the care i receive through my local CBOC is as excellent as clould reasonably be expected. In light of all these innovations ar the highest levels of theVA, I would prpose yet another program initative. Perhaps we could call it: Reducetion Of Limited Value Overly-nuanced Programs (ROLVOP).

  9. Joe Airman April 29, 2020 at 10:05 pm

    All of these innovations are noteworthy, but the bottom line is STILL the clinicians (us) veterans are treated by. I have been in the system as a patient and clinician for over 25 years. I have served under (as a resident physician) some great teaching and surgical physicians, sadly they are gone now. I grin with disgust everytime I am put on hold with the VA and hear that phrase, “You have served us, now let us serve you”. The level of care veterans receive is 2nd rate…AT BEST!!! The decisions for treatment plans, medication prescribing, test ordering/availability is a joke. So lets stop bullshitting the public and US VETERANS, telling us all that WE are receiving first rate medical care. It insults my intelligence!!!!!

    • Cheri Connelly April 30, 2020 at 1:23 pm


  10. James A Rourke April 29, 2020 at 9:51 pm

    Regarding “4-Sight”, has the wait time for optical appointments decreased? I have had eyeglasses three times using VA, and the process was long and tedious, plus the assortment of frames was very limited. I went to an ouside source this year, knowing it would be expensive, but I needed an accurate, precise prescription. Of course that didn’t happen and the aggravation and poor customer service became a battle. So I am going back to the VA system. Your article suggested that improvements have occurred, so I am going to try for an ASAP appointment at Phila VA. I enjoy the VAntage website.

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