A recent Government Accountability Office (GAO) report is calling into question the more than $1 billion that has been spent to modernize the Department of Veterans Affairs' (VA) health IT system.
The report noted that for nearly two decades, the VA has undertaken multiple efforts to modernize its health information system—the Veterans Health Information Systems and Technology Architecture (VistA). For these efforts, VA has relied extensively on assistance from contractors and has thus obligated more than $1.1 billion for contracts with 138 contractors during fiscal years 2011 through 2016 for this work across two major projects—the VistA evolution project and the department’s Integrated Electronic Health Record (iEHR) program, a joint initiative with the Department of Defense (DoD) that was intended to replace separate systems used by VA and DoD with a single system, a plan that was abandoned in 2013.
According to the GAO report, “Contract data showed that the 15 key contractors that worked on both programs accounted for $741 million of the funding obligated for system development, project management, and operations and maintenance to support the two programs.”
VA recently announced that it intends to change its VistA modernization approach and acquire a similar EHR system from Cerner that the DoD is implementing. A few weeks ago, during a House Appropriations Military Construction and VA subcommittee meeting, VA Secretary David Shulkin, M.D., said the department is facing a “time crunch” in its Cerner EHR project and that VA is requesting Congress to reprogram almost $800 million from its current budget to get started on the work. Some media reports have estimated that the cost of the entire project could be as much as $18 billion.
In 2014, to improve all major federal agencies’ acquisitions and hold them accountable for reducing duplication and achieving cost savings, in Congress enacted federal IT acquisition reform legislation (referred to as the Federal Information Technology Acquisition Reform Act, or FITARA). For this report, GAO was asked to summarize its previous and ongoing work regarding VA’s history of efforts to modernize VistA, including past use of contractors, and the department’s recent effort to acquire a commercial EHR system to replace VistA. GAO was also asked to provide an update on VA’s progress in key FITARA-related areas.
The report revealed that “With respect to key FITARA-related areas, the department has reported progress on consolidating and optimizing its data centers, although this progress has fallen short of targets set by the Office of Management and Budget. VA has also reported $23.61 million in data center-related cost savings, yet does not expect to realize further savings from additional closures.”
In addition, GAO concluded that although VA's CIO certified the use of adequate incremental development for 10 of the department's major IT investments, VA “has not yet updated its policy and process for CIO certification as GAO recommended. Finally, VA has issued a software licensing policy and has generated an inventory of its software licenses to inform future investment decisions,” the report stated.