Lawmakers balk at $350M addition to VA's health record deal

The $16 billion, 10-year electronic heath record software upgrade at the Department of Veterans Affairs is barely past the starting gate, but lawmakers are already worried about management and budgeting missteps that could put the project over budget and behind schedule.

health data (Supphachai Salaeman/Shutterstock.com)
 

The $16 billion, 10-year electronic heath record software upgrade at the Department of Veterans Affairs is barely out of the starting gate, but lawmakers are already worried about management and budgeting missteps that could put the project over budget and behind schedule.

The project's leader, former Navy Captain John Windom, tried to put the best face on the nascent project at a Nov. 14 House hearing, but members of a special subcommittee of the Veterans Affairs Committee formed to oversee the massive IT implementation clearly were worried about issues of accountability and transparency.

"Over the last 20 months we've succeeded in every milestone that we've encountered or desired to achieve," Windom said. "I've seen nothing but unity in pursuit of this mission amongst the entities that are alleged to have been fractured over the years. They have come together. I don't know if it's the stars aligning, but the stars have aligned."

Windom said that priority from VA Secretary Robert Wilkie and the fact that Windom himself has a direct line to James Byrne, the acting number two at VA, were key reasons for what he characterized as the early success of the project.

At the outset of the hearing, Rep. Jim Banks (R-Ind.), who chairs the subcommittee, expressed concern that Windom had only recently factored in the cost of the VA personnel working in a program management capacity to the overall Electronic Health Record Modernization budget projections – an addition of $350 million over 10 years.

"We need to have highly qualified subject matter experts to grade the implementation efforts of Cerner," Windom said. "Those people cost money."

At the same time, Windom noted that the EHRM office, which he leads, has been effectively downsized from its original projection of about 700 full-time employees down to an expected 269. Part of the reason for this, Windom said, is that the Veterans Health Administration and the Office of Information and Technology have been generous in providing experts to the Cerner project.

Windom also said the "full infrastructure plans" for the Cerner implementation were presented to staff on Nov. 13, and that the state of technology at the VA sites "revealed no showstoppers." That means, according to Windom, VA showed "similar and same deficiencies that [Cerner has] seen in a commercial implementation."

Project CTO John Short drilled into the details on the infrastructure front, telling the panel that VA wanted to complete computer and peripheral refreshes at most locations about six months ahead of Cerner implementations, although that time frame will be tighter at the initial operating capability sites in the Pacific Northwest.

Most VA computers, Short said, "are five years old and need to be replaced," and the EHRM project is being integrated with OI&T contracts, "so we don't have additional administrative overhead for those."

Travis Dalton, Cerner’s president of government services, admitted that "we learned some hard lessons with DOD," when implementation of the Cerner software under the MHS Genesis project at military hospitals in the Pacific Northwest was deemed "unsuitable for use" in a DOD report. Obsolete computers and networking gear caused some, though by no means all, of the problems with the rollout of the new software.

"We're doing a lot of things differently here," Dalton said, "engaging with sites early and often…activity we're doing here we didn't do with DOD."

Other issues that are likely to reappear as oversight of the project goes on include the level of data and system integration between the VA system and MHS Genesis.

Windom offered some early examples of where overlap will happen. For instance, DOD and VA will use the same web address to access the online system, and public key infrastructure certificates were recently issued for the shared URL. DOD and VA will also share a patient identity management system.

Banks also expressed concern about the ability of VA's Cerner system to share data with providers outside the DOD-VA system.

"Community interoperability is a very real problem and for $16 billion, VA had better solve it," Banks said."

Rep. Phil Roe (R-Tenn.), the chairman of the full committee, recommended the panel conduct oversight check-ins every 90 days over the life of the project and urged his successor to reconstitute the subcommittee for the next Congress.

Rep. Mark Takano (D-Calif.) is the presumptive chair of the House VA Committee in the next Congress. Current Ranking Member Tim Walz won his race for governor of Minnesota.

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.