Program Management

Integrated health record effort adds to VA's troubles

Eric Shinseki

In February, VA Secretary Eric Shinseki (pictured) and then-Defense Secretary Leon Panetta announced a shift in strategy that signaled a rift in the effort to create a joint electronic health record.

The Integrated Electronic Health Record (iEHR) program is not the Department of Veterans Affairs' only lightning rod, but it is a major one. Officially in the works since 2011, the records-sharing program took root after 15 years of discussion and cooperation between the two agencies to share military members' health data.

In 2012, however, cracks in the effort began to show. In September, the Government Accountability Office outlined hindrances to collaboration, cost documentation and performance measurement. GAO also highlighted fragmented processes across medical facilities -- a breakdown between regional offices and headquarters illustrative of VA problems writ large.

In February, VA Secretary Eric Shinseki and then-Defense Secretary Leon Panetta announced a shift in strategy that signaled a rift in the joint effort. The announcement was swiftly spurned by GAO and Capitol Hill. On Feb. 27, GAO issued another critical report stating that the change of course raised "concerns about the departments’ ability to successfully collaborate to share electronic health information."

The following week, Congress passed a continuing budget resolution that contained a stipulation suspending all but 25 percent of iEHR program funding for IT systems development, modernization and enhancement until DOD and VA satisfied the concerns of the House and Senate appropriations committees.

In April, Shinseki testified before Congress that VA would move forward with the electronic records-sharing program and said his agency is waiting for DOD officials to decide what core IT platform they want to use. VA is using its self-developed Veterans Health Information Systems and Technology Architecture, and VA officials had hoped DOD would do the same.

Shortly thereafter, Defense Secretary Chuck Hagel told House lawmakers that he had blocked the release of a request for proposals for a new core system pending further review. "I stopped it from going out [at] the end of March because I didn't think we knew what the hell we were doing," he said during testimony on April 16.

The program remains in limbo while DOD leaders mull the best way forward. Insiders say it is possible for the two agencies to share information without sharing the same core IT platform, but it could require jumping through extra hoops -- and, undoubtedly, spending more money.

About the Author

Amber Corrin is a former staff writer for FCW and Defense Systems.

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Reader comments

Sat, Aug 10, 2013

Thirty years old or not, as long as it’s developed in-house and NOT by one of many horrible companies that take the VA cleaners most would be OK with it. We’ve seen way too many instances of the DSSs of the world subjecting the VA to the trash code they write (yeah, ask and VA developer or FCIO!!), so we just have to stop thinking the private sector is the answer. They want a profit and that’s where it ends.

Thu, Jul 18, 2013

Sure, A 30 year old kernel written in a dead language is awesome. Unless you wanted anything encrypted, or FISMA compliant. So ... how do they plan to rewrite the Vista broker, Vista web and EVERYTHING that leverages it?

Fri, Jun 7, 2013

Totally agree, the VA has the best EHR out there. The fact that Mumps and VistA have been around as long as they have been and are still the only integrated health care software is proof of that. Does it need to be updated, most certainly. When Dr Gauss, Asst Sec for Info and Tech decided that VistA was 'antiquated' and that the VA should not be in the IT bsuiness, money ceased to be given for continued development. The VA needs to get back on track to update and improve their already great system. DOD would be well advised to get on board. VA's IT leadership needs to come together and be more unified. In essence, VA IT needs to return to its roots to shine brightly once more. (See Phil Longman's book "Best Care Anywhere: Why VA Healthcare is Better than Yours" - he explains why VistA is the best thing out there).

Sat, May 4, 2013

LOL, “DoD” has been using “VistA” (originally called DHCP) since SAIC got ahold of the code, filtered it, and called it CHCS. So DoD’s goofing around needs to end and let the VA lead the effort. Hey, the fact that VA wrote the best EHR on the face of the planet (yeah, see where “DHCP” has matriculated to around the globe!!), should end the debate on who knows more about EHRs! Just because VA doesn’t have the endless resources to bring fifty government and contract staff to each meeting doesn’t mean we’re not better at this than they are. They may be DoD, and the fighting part of the military is awesome, but after using their own militarized version of VA’s “self-developed” EHR since the 80s, it seems silly for them to claim to still be “evaluating” it. Wow, they’ve had it since the 80s, they’re a slow bunch aren’t they! As for Chuck saying, “because I didn't think we knew what the hell we were doing,” that about sums it up for DoD part of the party! Imagine that, after calls where it seemingly takes forever to take roll because of the regiment of humanity DoD brings along, they’re still left pondering what they might want to use. Why am I not surprised?

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