VA’s head of AI sees his role as a ‘bridge’ to future use

The Department of Veterans Affairs has been testing out a variety of AI use cases to determine how the tools can enhance veteran care and benefit services. As the department’s Chief Artificial Intelligence Officer and Chief Technology Officer, Charles Worthington said a large part of his work has been helping VA “bridge from where we are now to that future where AI is just kind of a component of most systems.”

Worthington recently spoke with Nextgov/FCW about how the VA is working to onboard new AI-powered capabilities and the department’s focus on making personnel comfortable with using the emerging technologies. This interview has been edited for length and clarity.

Nextgov/FCW: Who do you report to in your organization? How many people are on your team? And what are your plans for growth?

Worthington: As CTO I report to our chief information officer, and that didn't change with the chief AI officer designation. The CAIO role though has some specific requirements that are outlined in the department memo. These include advising the rest of the agency leadership on AI topics and kind of coordinating the VA’s AI activities via the governance council that we've stood up, as well as just a general kind of coordinating role. 

We have a relatively small group of folks dedicated to AI on the team that reports to me, about five full-time employees. But we also coordinate with a lot of the other parts of VA that also have nascent and growing AI teams, most especially with our colleagues in the Veterans Health Administration. They have an emerging technology area that has a big AI focus and we work closely with that group. In other parts of VHA and the rest of the agency, there's also a growing number of folks that are dedicated to AI that we also play kind of a coordinating role with. 

VHA recently centralized some of their technology-focused offices into an organization called the Digital Health Office. A number of the AI capabilities that were created within VA’s National Artificial Intelligence Institute are now part of that office. The function they have been playing is really helping identify and prioritize use cases in the healthcare space. They're playing a big role in basically facilitating the launch and the running of some specific pilots, and are also going to be playing a big role in the governance and risk management of AI in the healthcare space.

Nextgov/FCW: How do you see your role evolving over time?

Worthington: If you think ahead 10 years, I think it's pretty likely that features that we would now categorize as AI will be just a part of most software systems in use. We’ll think of them as not necessarily a different category of tech, but rather, just a way that a lot of software works. 

So I think in a lot of ways, the job that we have as chief AI officers right now is to help bridge from where we are now to that future where AI is just kind of a component of most systems. And to do that effectively and safely, we're going to have to basically update the various ways that the government does technology management to account for the things that are unique about AI.

It's a little hard to predict how to how it's going to evolve, but I do think that the next year or two, it's basically trying to figure out how can we safely apply this technology in the government and what sort of changes do we need to make to our existing policies and procedures to make that true. And then I think those changes will be the sorts of things that can kind of carry us into that future where these AI components are just kind of built into most systems that we use.

Nextgov/FCW: What is your role in things like AI acquisition and workforce development?

Worthington: One of the four work streams that we're focused on in our AI governance framework is workforce development, and we've got a whole group of folks dedicated to that. We're lucky to have participation from our human resources office as well as key HR leaders across the agency, and they have put out this AI workforce blueprint that kind of lays out some approaches that we're going to be experimenting with. The work, I think, is going to be helping our staff understand how these tools work and how they can use them. And so as we're starting to roll out software that has these features built in, we're also thinking about how we can train people and get them comfortable with what they can and can't do.

I think a lot of the conversation around AI workforce has tended to focus on how we get those technical experts that understand how to create AI systems, which is definitely important. But there's this whole other part of the work stream, which is more about, “how do we make our existing staff understand how to use these tools and what their limitations are to maximize productivity and the impact they can have along those lines?”

When it comes to onboarding new tools, there's kind of two ways to approach this. One is use case by case, where you're trying to solve specific problems or make a specific business process work better. We've got a number of things in production, as shown in our current use case inventory, and also a number of things that are sort of in pilot. I think starting with problems and then figuring out what technology is best suited to solve that problem is the best way to proceed with any sort of tech rollout. 

For our most important problems — for example, clinician burnout is one of these problems that we’re trying to tackle — we’re thinking about ways in which technology, including AI, might be able to help with that. That's what led us down the path of testing these ambient scribe products, which can help with clinician workflow and help with some of the grunt work of writing down a clinical note, and potentially make that a little bit faster and less tedious. So I like approaching things that way, where we're starting with the problem in mind and then figuring out what tech might fit and then going and acquiring it if we need it.

Nextgov/FCW: Can you discuss your approach to the combined CAIO and CTO role and how they complement one another?

Worthington: There’s a fair amount of overlap. The mission of VA’s CTO … is to basically enable VA to improve veterans lives with better software. I think artificial intelligence is probably the most important thing that will change about software in the next 10 years. So in that sense, I think it's right in line with what we’re already supposed to be doing. We're constantly looking for ways to improve VA’s use of software so that we can have a more positive impact on veterans.

Nextgov/FCW: What is your biggest priority right now?

Worthington: We're learning alongside everyone else. I think we're definitely lucky to have had the Veterans Health Administration, and the investment that they made in the AI capability early on. I think that actually reflects this sort of rich culture of innovation and experimentation, especially in our healthcare administration. The VHA has done a lot of groundbreaking research, not just in AI, but dating back to things like the pacemaker and the nicotine patch. So our Health Administration is really good at thinking about things they could improve that would help the delivery of healthcare to veterans and nationwide. So I think that that ethos of experimentation – but really rigorous experimentation grounded in research principles – has been really helpful for VA to get started. I think that really allowed for us to think through adopting those trustworthy AI principles, because I think a lot of those are kind of in line with how we think about running the VA already. 

We want to be very fair and equitable, but we also want to take advantage of existing technology or even create new technologies that will help us achieve the mission better.