Chairwoman Wasserman Schultz Statement at Electronic Health Record Modernization and Information Technology Oversight Hearing
Congresswoman Debbie Wasserman Schultz (D-FL), Chair of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Subcommittee, delivered the following remarks at the Subcommittee's hearing on "Electronic Health Record Modernization and Information Technology Oversight":
Today we welcome James Byrne, the General Counsel, Performing the Duties of the Deputy Secretary, James Gfrerer, the Assistant Secretary for Information and Technology, and Chief Information Officer, and John Windom, the Executive Director of the Office of Electronic Health Record Modernization.
The focus of this oversight hearing is to discuss VA’s efforts to modernize its Electronic Health Records Platform and general information technology issues at the Department.
Before we dive in, I want to walk everyone through the EHR timeline thus far, and the unbelievably lengthy process this has been – which I had the staff put on paper for Members, and would like to include it in the record, without objection.
In 1998, during the Clinton Administration, a Presidential Review Directive acknowledged that the Department of Defense and VA systems were not compatible and that actions should be taken to identify data exchange systems.
In 2003, President Bush established a taskforce to Improve Health Care Delivery for Veterans, which recommended that the Departments develop an interoperable record.
In 2007, the President’s Commission on Care for America’s Returning Wounded Warriors also supported interoperability: the genuine ability of these two systems to seamlessly exchange and make use of the other’s information.
Then in 2009, President Obama announced that DOD and VA would be working together to build a seamless system of integration. By 2011, VA Secretary Shinseki and Department of Defense Secretary Robert Gates announced plans to create a single electronic record.
However, just two years later, in 2013, the two Departments announced that they would no longer create a single, common health record, and instead focus solely on interoperability. The VA chose to modernize its existing VistA health record in-house, while DOD announced it would contract a commercially produced health record.
In response to that problematic announcement, the House-reported Fiscal Year 2014 Milcon-VA bill directed the VA and DOD to develop a single electronic health record.
After discussions at that time with the House Armed Services Committee, the provision was removed from the bill. The final Appropriations language permitted either a single system or two interoperable records.
After that battle was lost, DOD went on to award a $4.3 billion contract, with Cerner as the sub-contractor, to develop the DOD health record modernization, and so far has spent $5 billion on this endeavor. At the same time VA’s efforts to modernize VistA underwent further review.
We can agree this would not have led to genuine interoperability and the patch work of the Joint Legacy Viewer has left much to be desired.
Finally, earlier this summer, the VA announced its intention to award a single source contract to Cerner to provide VA the same electronic health record system that DOD is developing, and it will follow the same rollout cycle being operated by DOD.
And most recently, this subcommittee held a closed hearing to discuss the Cerner contract before it was signed by Secretary Wilkie – but not before this subcommittee was asked to approve a $782 million reprogramming request from Medical Services at the end of October 2017, and that needed to be acted on by November – with no real details provided.
Luckily for VA, we had not finished work on the FY 2018 bill, so we were able to provide this money during the regular process because no one supported taking money away from Medical Services.
Long story short, this issue could have, and should have, been resolved years ago. When I think about the time and resources that have been wasted over the years on this endeavor, it is easy to see why Members have such strong feelings and such frustration concerning this issue.
I am genuinely pleased the VA is moving in the direction of creating an integrated health record system with DOD, but I am concerned about how this new system will work with the private sector providers.
With the new Mission Act access standards, more Veterans will be seen in the private sector. We need to ensure that the new EHR system will be able to seamlessly exchange data between the private sector and VA.
I am also concerned about the cost and the projected timeline. As I said just last week to Secretary Wilkie, this is a complex project that is projected to cost 16 billion dollars, which is more than the nuclear-powered aircraft carrier USS Gerald R. Ford, the lead vessel of the U.S. Navy’s latest class of carriers. It comes in at a cost of 13 billion dollars.
I am also concerned about the projected 10-year deployment plan. We must get this new system in place, as it could possibly be the difference between life and death for our Veterans.
Mr. Byrne, implementing and improving VA’s Electronic Health Record system and executing Congress’ mandate for full interoperability with DOD’s systems has been a top priority of this Committee for several years.
Finally, I am concerned about the lack of permanent leadership. Mr. Byrne. You are clearly capable of preforming the duties of the Deputy Secretary, which you have done since August 28, 2018 as Acting Deputy Secretary and now as the Executive in charge, due to your Acting role lasting longer than the law allows for.
The Deputy Secretary is supposed to oversee the EHR modernization, which is a huge undertaking that could fundamentally change how our country deals with Electronic Health Records.
And stability is one of the many important factors that will have an impact on whether the implementation is successful or not.
As you can see, we have a lot to cover today and I am looking forward to a robust conversation.