Standardizing Care: How Aptive Uses SAFe to Help VA Standardize the Federal EHR
Standardizing Care: How Aptive Uses SAFe to Help VA Standardize the Federal EHR
by jillian gates
A Veteran who sees a doctor in one state and fills a prescription in another should meet the same quality of care, backed by the same record, wherever they go. For years, that hasn’t been guaranteed. The Department of Veterans Affairs (VA) has run more than 130 separate instances of the Veterans Health Information Systems and Technology Architecture (VistA) and the Computerized Patient Record System (CPRS), each shaped by years of local customization. Staff have a saying: “if you’ve been to one VA, you’ve been to one VA.”
VA is changing that. By deploying a single Federal Electronic Health Record (EHR) across 1,380 sites of care, the largest integrated health care system in the nation, VA is building toward one consistent standard of care, a unified Veteran experience and a record that travels with the person, not the facility. Scaled Agile Framework (SAFe) gives VA a way to adjust quickly while keeping every stakeholder aligned, which is what keeps standardization consistent even as the program changes underneath it.
Why Standardization Matters
Standardization isn’t uniformity for its own sake. When workflows, tools and clinical reminders are consistent, care gets safer and faster: fewer workarounds, less duplicated documentation and fewer chances for something to slip between systems. It eases the load on staff, who no longer need to relearn the basics each time they move between sites, and it makes the record interoperable, so a Veteran’s history follows them across the systems they actually use.
VA has started closing the gaps, deploying the Federal EHR to create a single, integrated record for every Veteran, standardizing the experience for both Veterans and their providers. However, there is a lot of work behind the scenes to prepare for deployment and sustain operations after the Federal EHR goes live.
Secret to Success: Scaled Agile Framework
A single standard of care doesn’t arrive with the software. It has to be built into the workflows, tools and habits people use every day. That is where Aptive supports VA, standardizing the operating model behind the transition: how workflows are designed, how issues are taken in and resolved and how decisions get made across sites.
Standardizing how VA works calls for a standardized way of working, too. Aptive uses SAFe methodologies: one shared cadence and one shared playbook across a complex, multi-stakeholder program. Operating the Veterans Health Administration (VHA) EHR Issue Management Process, the team manages a large enterprise backlog in two-week sprints, sequencing the highest-value, most time-sensitive work first so the issues that matter most move fastest. Quarterly program increment planning sets the priorities, Agile Release Train-style coordination with VA’s Office of Information and Technology surfaces cross-team dependencies early and day-to-day tracking gives leaders real-time visibility into what’s moving and what’s stuck.
With this framework, the EHR Issue Management Process and its tiered hubs turn a single facility’s solution into a standard applied everywhere. The result: cutting resolution times by 81% at the facility level and 51% at the national level. Aptive managed the development of the Tiered Hub Process itself and is now consolidating issue management onto a single tool, moving from the Risk Management Application to YourIT/ServiceNow, so every site reports, routes and resolves problems the same way, from intake and root-cause analysis through the standard operating procedures that keep each resolution consistent.
The Aptive team uses SAFe sync and sprint cadences to guide coordination with leaders and staff across more than 10 national VHA program offices, all 18 Veterans Integrated Service Networks and 172 facilities to keep issues moving and resolutions consistent from one site to the next.
Standardization also depends on people choosing to adopt it, which is a training and communications challenge as much as a technical one. Aptive leads role-based, “use it tomorrow” training so site teams can put consistent workflows into practice without losing time at the bedside, and pairs it with an award-winning strategic communications plan, informed by the Federal EHR User Experience Survey and adapted SAFe methodologies, that reaches staff with the right message at the right time.
The Payoff for Veterans
The result of a single EHR, and all the work before, during and after deployment, is clear: Veterans get the same quality of care whether they’re seen across town or across the country, and staff caring for them spend less time fighting the system and more time on the person in front of them.
As of March 2026, Aptive’s work to help VA standardize has led to the resolution of more than 2,244 enterprise-level EHR issues across both the legacy and Federal EHR, and has provided nearly all of VA’s facility staff with the training and communications they need to prepare for, and use, the Federal EHR effectively.
The goal isn’t a single system for its own sake. It’s a day when a Veteran can walk into any VA, anywhere, and find the same record, the same workflows and the same standard of care waiting for them, so “if you’ve been to one VA, you’ve been to one VA” is no longer true.
About the Author:
Strategic communications manager Jillian Gates brings deep experience translating complex health IT modernization into clear, human-centered stories that drive adoption and trust. At Artemis ARC (a teaming partner of Aptive’s), she leads an award-winning communications team supporting VA Electronic Health Record Modernization. As a SAFe 6 Agilist Certification, Jillian adapts SAFe methodologies into agile processes for communications and change teams.