The House Committee on Veterans Affairs passed legislation this week that aims to improve health data exchange between VA healthcare providers and community care providers, including a provision to ensure community healthcare providers have access to relevant patient medication prescription information to ensure safe opioid prescribing practices.
The bill, H.R. 5674, or the VA Maintaining Systems and Strengthening Integrated Outside Networks Act (MISSION) of 2018, clarifies that VA could share medical information with non-department entities for the purpose of providing health care to patients or performing other healthcare -related activities.
In a section focused on establishing processes to ensure safe opioid prescribing practices by non-VA healthcare providers, the bill mandates that the VA implement a process “to make certain that community care providers have access to available and relevant medical history of the patient, including a list of all mediation prescribed to the veteran as known by VA.” Further, contracted providers would be required to submit medical records of any care or services furnished, including records of any prescriptions for opioids, to VA. “VA would be responsible for the recording those prescriptions in the electronic health records and enable other monitoring of the prescription as outlined in the Opioid Safety Initiative,” the bill states.
The legislation also enables VA care providers to utilize state prescription drug monitoring programs (PDMPs). “Section 134 would allow any licensed health care provider or delegate to be considered an authorized recipient and user for the purposes of querying and receiving data from the national network of State-based prescription drug monitoring programs,” a committee summary of the bill states.
The House committee also passed H.R. 4245, the Veterans’ Electronic Health Record Modernization Oversight Act of 2017, which directs VA to provide Congress with the project’s key planning and implementation documents, in addition to copies of the contracts, to indicate the effort’s progress and how the money is being spent. The bill also requires VA to notify Congress in the event of any significant cost increase, schedule delay, loss of veteran health data or breach of privacy.
A committee summary of the bill notes that the VA’s migration to the Cerner electronic health records system will be one of the largest contracts and projects in VA’s history, and that Congressional oversight is critical to ensure this effort is carried out responsibly and successfully. “This legislation would give Congress additional tools to carry out effective oversight on VA’s transition to its new electronic health records system,” the summary states.
The VA’s move to modernize its EHR has been put on hold since December when VA leaders announced a “strategic pause’ on negotiations with health IT vendor Cerner, with the purpose being to conduct an assessment of national interoperability language contained in the Request for Proposal that would ultimately support an EHR contract award. The VA announced back in June plans to replace its aging EHR system, called VistA, by adopting the same platform as the U.S. Department of Defense (DoD), a Cerner EHR system. In the past few months, there has been major leadership changes at the agency, with President Donald Trump firing VA Secretary David Shulkin, M.D., back in March, followed by Trump’s VA Secretary nominee Ronny Jackson, M.D. withdrawing his nomination. The leadership changes have called into question the status of the VA-Cerner contract.
Just this week, a VA leader told Congressional lawmakers during a Senate appropriations subcommittee hearing that the Acting VA Secretary Robert Wilkie would make a decision on the EHR acquisition process and the potential contract with Cerner by May 28.