The House Appropriations Committee has cleared the fiscal year 2018 Military Construction and Veterans Affairs Appropriations bill, which includes $65 million for the modernization of the VA electronic health record (EHR) system.
The $65 million allocation for the IT modernization project is the same as what President Trump requested in his 2018 budget request a few weeks ago. It was announced last week by VA Secretary David J. Shulkin, M.D., that the department will replace its aging EHR system, VistA, by adopting the same platform as the U.S. Department of Defense (DoD), a Cerner EHR system. “However, the agency also said that while it would be a similar Cerner platform as DoD, it would not be identical, citing the need to create an ‘integrated’ product in order to achieve interoperability with other healthcare provider organizations,” Healthcare Informatics’ Heather Landi reported on June 5.
However, according to a draft of the legislation released June 11 by the House Appropriations Committee, the two systems will be identical. The draft said that the funding “will ensure the swift implementation of the plan for the VA to use an identical electronic record system as the DOD. This will also ensure our veterans get proper care, with timely and accurate medical data transferred between the VA, DOD, and the private sector.”
The DoD awarded a multi-billion dollar EHR contract in 2015 to Leidos and Cerner. Although initial deployment was set to begin in December 2016, the contract was delayed and the deployment began this past February. The cost of that project has been reported to be more than $4 billion. As reported by Politico Morning eHealth this week, “It’ll cost a great deal more than [$65 million], of course, to implement a new EHR at the VA. Shulkin plans to go back to Congress with a much bigger proposal once he figures out the details of the switch to Cerner.”
The VA Appropriations bill, as it relates to the EHR upgrade, has restrictions attached to it, noting that “not more than 25 percent [of the funding] may be obligated or expended until the Secretary of Veterans Affairs submits to the Committees on Appropriations of both Houses of Congress.” The specific conditions include:
- A detailed explanation of the solicitation submitted to Cerner Corporation for development of an electronic health record for the VA.
- An explanation of how the electronic health record would replicate the Military Health System (MHS) Genesis record developed by Cerner for the Department of Defense, as well as the enhanced capabilities the Department of Veterans Affairs requires to achieve complete interoperability with the Department of Defense system and non-Department of Veterans Affairs providers who participate in the Department of Veterans Affairs healthcare system.
- A strategic plan for development of the electronic health record system, an associated implementation plan including timelines and performance milestones, a master schedule and annual and lifecycle cost estimates.
- Information on plans to maintain current functionality and integration with Department of Defense records during the transition to MHS Genesis.
- VA plans to manage the transition process to MHS Genesis, including possible pilot programs, training for users and use of change management tools.