Veterans Care Today: Alicia Harkness Of Guidehouse On How The US Has Improved Its Care For Veterans Over The Past Five Years

An Interview With Eric Pines

You don’t need to know your passion on Day 1. Be curious. Find what makes you happy and find meaning in every experience. This will help you find your purpose. When I started out, I didn’t know what my passion was — I later found it in healthcare by moving between engagements and client experiences.

The daily headlines remind us of how countries around the world care or do not care for their military service members. How does the US care for Veterans compared to other comparable countries? What exciting new technological or methodological innovations are being used to improve Veterans’ health outcomes? To address these questions, we are talking to successful physicians, healthcare workers, Veterans, or other VA employees and officials who can share stories and insights from their experience about the state of Veterans’ care today and how the US has improved its care for Veterans over the last five years.

Alicia Harkness is a partner and the leader of Guidehouse’s Health segment. She is passionate about positively impacting the healthcare ecosystem by enabling access to care; improving health equity and patient experiences; designing cost-effective care delivery models; and efficiently fast-tracking the release of lifesaving drugs and therapies to the market. Under her leadership, the Guidehouse Health team brings together clinical, operational, technological, and analytics capabilities and expertise from diverse commercial and public health backgrounds to solve the industry’s most complex challenges.

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?

I was going to be a concert pianist, at least that is what 14-year-old me believed. I had taken lessons since I was 5 and regularly competed. However, I decided to major in business in part because of what I liked about playing piano. I liked exploring compositions and creating something unique each time I played. I was excited about the opportunity to do that in the business world.

I began my career as an analyst at a global consulting firm, where I supported the U.S. Department of Defense (DoD). Later, I worked on a project at the Defense Advanced Research Projects Agency, monitoring research dollars and initiatives at academic medical centers. Monitoring the financial management side of research was interesting to me, as the funder and grantee worked together to achieve their research outcomes like a music piece. Changing one part of a project affected other parts. I progressed to supporting similar projects in their healthcare and education consulting practice and was proud to quickly achieve a leadership position as partner.

At that point in my career, I had spent a lot of time implementing new technology for state and local government, higher education, and healthcare organizations. I explored a multitude of industries and learned how to solve the most complex challenges for a range of organizations.

I was then hired into a leadership role at another global consulting company and ultimately ended up leading their healthcare commercial payer/provider business. However, I am most proud of my next career move. Trusting my gut, I joined a start-up backed by a world-class private equity firm, Veritas Capital. Together with a team of exceptional partners, we created the next-generation, global consulting powerhouse I work for today: Guidehouse. I’m honored to lead Guidehouse’s global Health segment, tackling some of healthcare’s most complex issues.

Chopin Étude Op. 10 №4 is widely known as a complex musical piece to play. It takes quick thinking as the pace is very fast and your fingers feel like they are on fire when you play. You can easily stress out. However, I was taught not to be overwhelmed by complex pieces but to tackle them measure by measure and note by note. And that is how Guidehouse is delivering value. We organize around the components of healthcare’s commercial and public sector industries so that we can compose something unique and meaningful to the totality of the healthcare ecosystem, bringing best practices from one to the other.

Our motto is outwitting complexity and I am grateful to deliver on that challenge every day.

Can you share the most interesting story that happened to you since you began your career?

I was a competitive swimmer in my youth and had been taught to look at each loss as a learning experience. Could my dive have been better? Did I take too many breaths? What can I do differently next time? How can I win next time?

When we lost a pursuit for a significant opportunity early in my career, I used it as an opportunity to learn something. Upon reflection, it was clear to me that we had the right solution, but we failed to tell our story.

I believed in what we offered and leveraged that passion to get in front of the client to tell our story. We ended up winning the work, delivering on a four-year transformation program. That experience further proved if you believe in something, you keep fighting (and keep swimming). Change can happen but you must make it happen.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“It is better to light a candle than curse the darkness.”- Eleanor Roosevelt. This quote has led my way as I have encountered challenging personal and professional situations.

That quote is about being solutions focused. As a leader at Guidehouse, I strive to be a torchbearer to illuminate the opportunities we have as a collective team and inspire our team to forge a new path.

I’m so grateful to work with such passionate people, solving challenges that impact communities, workplaces, and organizations across the globe. There can be patches of darkness in healthcare…it’s complicated, expensive, fragmented, etc. but we are lighting the candle. We continue to grow as an integrated Health team with perspectives and experiences from both the regulator and regulated industries that shed light on opportunities for change.

Are you working on any exciting new projects now? How do you think that will help people?

We are always working on exciting new projects. Across Guidehouse’s Health segment, we help providers, government agencies, life sciences companies, employers, payers, and other organizations modernize and innovate services, finances, and operations. We are focused on positively impacting the healthcare ecosystem by enabling access to care; improving health equity and patient experiences; designing cost-effective care delivery models; and efficiently fast-tracking the release of lifesaving drugs and therapies to the market.

The work we do ranges from improving integrated Veteran care; to COVID-19 vaccine development, commercialization, and deployment; and helping health systems save millions in financial and operational efficiencies while driving quality improvements. While healthcare is our business, we are deeply passionate about the people impacted by that business. Our work is directly helping people from identifying a Veteran at risk for suicide to getting drugs to market faster, so a mother gets to add another birthday candle to her daughter’s birthday cake. We recognize that healthcare is more than a business and it’s an honor to support an industry that directly affects every person.

To do that requires an ever-expanding set of capabilities and Guidehouse has made two exciting acquisitions in the past year. In 2022, Guidehouse acquired Grant Thornton’s Public Sector Practice, adding solutions and people with expertise in finance, human capital management, information technology, data analytics, and performance management.

And in 2021, we acquired Dovel Technologies, a provider of advanced technologies and experts that support the health IT, life sciences, public safety, and grants management markets. That acquisition strategically expanded our healthcare-specific expertise in pre-clinical and clinical research, grants management, clinical care, biomedical innovation, bioinformatics, advanced analytics, digital modernization, software and infrastructure development, and more. With these new capabilities, we recently launched Guidehouse Digital, which focuses on mission-critical projects that transform the market and support clients in solving their most complex challenges through digital innovations and transformations.

How would you define an “excellent healthcare provider”?

My technical answer is: An integrated system that delivers whole-person, accessible, high-quality care with empathy and compassion. That means preventive care, treatment, and therapy no matter the race, place, time, medium, or cost. I’m very passionate about health equity. At Guidehouse, we are committed to addressing factors that impact health disparities for underserved and marginalized populations.

My personal answer is: As a wife, mother of two, and care provider for my aging father, an excellent provider would deliver the best experiences and outcomes for the people I love, allowing them to live better and longer. That is what makes everything we are doing in healthcare special to me because we are all consumers.

Ok, thank you for that. Let’s now jump to the focus of our interview. Based on your experience can you please share three recent improvements to Veterans’ care that you are really pleased about?

I am very pleased with the performance of our team but what pleases me is knowing that we have significantly moved the needle on improving the Veteran experience.

First, I’d like to talk about improved access. Through several programs we support, the administrative burden on providers has been reduced and the care delivery process has been modernized by transforming VA’s provider referral process, making it more efficient by building relationships and trust with community care providers. These providers now have more flexibility to deliver care to Veterans, including enabling VA to accept requests for services directly from community providers.

This process, along with VA’s efforts to create standard episodes of care and improve utilization management strategy with community providers, is building momentum by reducing wait times in the community and ensuring that when a Veteran receives care, they can expect the same high-quality care they would receive at a VA facility, anywhere.

Second, we’re helping standardize care. We’ve been working with VA on its 10-year journey to create a single, longitudinal electronic health record (EHR) from active duty through Veteran status. It’s been an incredible effort that will connect VA’s EHR to the DoD’s EHR, and to community providers through a health data exchange, making it easier for Veterans to visit VA, DOD, and community providers seamlessly.

And finally, suicide prevention. Guidehouse has been working in the mental health space over the past decade and was an early partner to VA in helping them use data to assess individuals at most risk. Our (in)Sight Health Catalyst IT platform identifies potentially imminent cases where Veterans need immediate suicide intervention support using publicly available information from digital platforms like social media.

In contrast, can you highlight three areas of Veterans’ care that still need improvement? What would you suggest needs to be done to address those challenges?

It’s important to remember that VA supports a beneficiary population that was first served by the Military Health System (MHS) — a separate and distinct system for active military personnel, their families, and military retirees. While there is a significant amount of coordination between the systems, even greater integration would better serve our current and former service members.

VA is one of the largest health systems and workforces in the country. They are leaders in cutting-edge research and innovation. Their EHR was one of the first to be developed. VA has taken on many modernization efforts and is incorporating its own best practices and those from commercial organizations. These learnings are being implemented across the board from a local health clinic in Nebraska, to a large medical center in Florida. And the same thing applies in the commercial space — they too are learning best practices from VA. These include community care improvement, as well as high-reliability organization transformation efforts.

In fact, the Defense Health Agency (DHA) recently launched a program called Ready Reliable Care Optimization, which seeks to capitalize on statutory changes that resulted in the consolidation of roles and responsibilities inside the MHS. Together, VA and DHA should embrace opportunities for broader integration with each other and the larger healthcare market to improve access while driving greater efficiencies in care delivery.

VA will continue to have a significant influence on the broader healthcare system, but it is critical that these best practices be captured effectively to enable them to be scaled, and ultimately impact the overall health of the broader U.S. population.

From your perspective how does the US care for Veterans compared to other comparable countries?

The U.S. is dedicated to caring for every Veteran who has served our country. A bronze plaque adorns VA’s headquarters building in Washington, D.C. with its mission statement which is “to care for those ‘who shall have borne the battle’ and for their families, caregivers, and survivors.” This is seen in part by how the Veteran population has been segmented to receive specific care.

The U.S. is an open healthcare system which led our government to create a direct care system for Veterans in the Veterans Health Administration. Everything that VA does permeates around the specific needs of Veterans and the needs of that segmented patient population.

Other countries, and even the commercial market, can learn from VA, considering everything from predicting Veteran needs based on their service, to social determinants of health, and more.

What exciting new technological or methodological innovations are being used to improve Veterans’ health outcomes?

VA has a rich history of innovation and breakthroughs, from the first liver transplant in the 1960s to a 3D-printed hearing device in 2021. VA’s Office of Healthcare Innovation and Learning advances healthcare by driving innovation, fostering a learning culture, and facilitating broad collaboration.

To evolve on this journey, VA established the Accelerating VA Innovation and Learning (AVAIL) contract to augment its innovation engine further and enhance its contributions to advancing healthcare. This contract will have a sole purpose to drive innovation that brings solutions directly to Veteran healthcare — from personalized medicine, immersive technologies, and components of their care such as data transformation, digital health, and care delivery. Having worked on many innovation initiatives across the commercial healthcare market, I do not doubt that digital twins will be part of the future of population health.

VA also recently issued Mission Daybreak — a $20 million grand challenge to reduce Veteran suicides. This landmark event asked all innovators to bring their best solutions to the table on how to impact Veteran suicide numbers. Having previously worked with VA to address Veteran suicide and mental health, Guidehouse’s submission to the challenge addresses upstream indicators of suicide, such as opioid use, and combines that data with social media and population health insights to create a risk predictor that VA can plug directly into their already existing clinical risk-predictor REACH Vet.

There has also been a transition on treating the whole Veteran and not just each medical need. The Whole Health initiative at VA is implementing new provider training and Veteran programs that bring complementary therapies together with standard care. VA has also been a pioneer in the medical home model, which is something that commercial providers can learn from. We are fortunate to have been helping to assess and build strategies that are working with VA to transition from sick care to a whole healthcare system for the care of the Veteran, Veteran self-healing, self-care, and self-empowerment.

Wish Someone Told Me When I First Started My Career”?

• You don’t need to know your passion on Day 1. Be curious. Find what makes you happy and find meaning in every experience. This will help you find your purpose. When I started out, I didn’t know what my passion was — I later found it in healthcare by moving between engagements and client experiences.
• Learn from everyone you work with — both the good and the bad. Some of my coaching styles came from my experiences having had both great, and not-so-great leaders. I have crafted my leadership style from what I want to replicate, what I don’t ever want anyone else to experience, and the difference I can make for my team. For example, early in my career, I had a manager who never provided positive feedback. This was not motivating to me so I vowed that when I was a leader, I would share constructive criticism, but also take the time to celebrate the positives. I feel the outcome is that you can build a more authentic and motivating culture.
• Listen twice as often as you talk. You learn a lot that way and better connect with your clients / team members when you understand what their true needs or wants are. It can be as simple as pausing before you speak, asking a follow up question, and reflecting on whether you have allowed your colleague or client to share their full perspectives.
• Look for the “sparkle” in everyone that you work with. Not everyone is alike. Find people’s strengths and create opportunities for them to show those talents.
• Relationships are the key to success. The impression that you make on someone can lead to a strong relationship. Make the most that you can of them. You never know where these relationships can take you, and how they will impact your future career track.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I will go back to the point I mentioned earlier: look for the sparkle in everyone. Focus on people as individuals: the power of our differences inspires innovation.

You can’t be successful in this business if you don’t provide differentiated quality service and you can’t create a differentiated service without diversity of thought. It’s not simply about creating diverse teams but also creating a culture that encourages anyone to challenge the status quo.

On one of our recent team calls, I reminded our team that if they were on the call, they were on the call for a reason and encouraged them to show why. I see their value. I see their sparkle but they need to be comfortable enough to show it and shine.

#Showyoursparkle…let’s start the movement.

How can our readers further follow your work online?

Stay up-to-date on my team’s healthcare insights by visiting the Guidehouse Center for Health Insights and following us on LinkedIn.

This was very inspiring. Thank you so much for the time you spent with this. We wish you continued success and good health!

About the Interviewer: Eric L. Pines is a nationally recognized federal employment lawyer, mediator, and attorney business coach. He represents federal employees and acts as in-house counsel for over fifty thousand federal employees through his work as a federal employee labor union representative. A formal federal employee himself, Mr. Pines began his federal employment law career as in-house counsel for AFGE Local 1923 which is in Social Security Administration’s headquarters and is the largest federal union local in the world. He presently serves as AFGE 1923’s Chief Counsel as well as in-house counsel for all FEMA bargaining unit employees and numerous Department of Defense and Veteran Affairs unions.

While he and his firm specialize in representing federal employees from all federal agencies and in reference to virtually all federal employee matters, his firm has placed special attention on representing Veteran Affairs doctors and nurses hired under the authority of Title. He and his firm have a particular passion in representing disabled federal employees with their requests for medical and religious reasonable accommodations when those accommodations are warranted under the Rehabilitation Act of 1973 (ADA). He also represents them with their requests for Federal Employee Disability Retirement (OPM) when an accommodation would not be possible.

Mr. Pines has also served as a mediator for numerous federal agencies including serving a year as the Library of Congress’ in-house EEO Mediator. He has also served as an expert witness in federal court for federal employee matters. He has also worked as an EEO technical writer drafting hundreds of Final Agency Decisions for the federal sector.

Mr. Pines’ firm is headquartered in Houston, Texas and has offices in Baltimore, Maryland and Atlanta, Georgia. His first passion is his wife and five children. He plays classical and rock guitar and enjoys playing ice hockey, running, and biking. Please visit his websites at www.pinesfederal.com and www.toughinjurylawyers.com. He can also be reached at eric@pinesfederal.com.