Health IT

House seeks details on VA's health record push

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House Republicans are seeking clarity and detail from the Department of Veterans Affairs on plans to improve the Veterans Health Information Systems and Technology Architecture electronic health record system and make it interoperable with a Department of Defense effort that is still in the planning stages.

The appropriations bill that funds the VA and military construction, which the House passed April 30 by a vote of 416-1, requires the agency to update Congress on progress to modernize VistA, since it decoupled its efforts to create an integrated health record from those at Defense in February 2013.

The two-year appropriation backs more than $3.8 billion for IT and about $550 million for systems modernization, but only 25 percent of the funding can be released until VA shares a development roadmap on VistA Evolution -- including any re-scoping, changes to cost estimates, testing plans and other efforts to ensure interoperability with the DoD system.

"The committee does not intend to delay the progress of developing the health record, but believes continuing oversight is necessary to ensure that the health record will have the capabilities and interoperability promised in the VA documents," appropriators wrote in their committee report on the bill.

Rep. John Culberson (R-Texas), chairman of the Appropriations subcommittee that funds VA, wrote in an April 30 op-ed that he expects similar language in the Defense authorization bill, requiring that Congress be kept in the loop on development of an electronics health records system at DOD.

The Obama administration is opposed to any delay in the release of money. While the administration is pleased with the funding levels in the bill, the Office of Management and Budget said in an emailed statement that "uncertainty in funding availability will delay needed enhancements for improved clinical decision support and better care for veterans."

"Significant steps toward improved interoperability have already been taken, including deployment of a joint legacy viewer to view patient records and improvement of data standardization between the Departments and patient identity management within both Departments," OMB said.

VA, meanwhile, is moving full steam ahead on the VistA Evolution plan. The department announced plans to use a public contest to solicit ideas for the revised health care record system in an April 25 notice published on the website. The competition allows VA to solicit expert and academic input for its new technical architecture that it might not otherwise be able to obtain under contracting rules.

The news comes as the VA is planning to pitch VistA Evolution as a candidate to serve as the DoD's electronic health record system. Secretary Eric Shinseki announced those plans at a House Veterans Affairs Committee in March. At the same time, private sector players are gearing up to compete to serve as integrator on the $11 billion DOD contract. A final request for proposals is expected to be released sometime in May. 

About the Author

Adam Mazmanian is executive editor of FCW.

Before joining the editing team, Mazmanian was an FCW staff writer covering Congress, government-wide technology policy and the Department of Veterans Affairs. Prior to joining FCW, Mazmanian was technology correspondent for National Journal and served in a variety of editorial roles at B2B news service SmartBrief. Mazmanian has contributed reviews and articles to the Washington Post, the Washington City Paper, Newsday, New York Press, Architect Magazine and other publications.

Click here for previous articles by Mazmanian. Connect with him on Twitter at @thisismaz.

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Reader comments

Wed, May 7, 2014 Joseph Mischbuccha

Sinseki thinks he's done great, but the record of his most recent CIO, and of the fleet of the usual contractors, suggests the organization can't spell IT systems. It over-buys, mismanages, accepts shoddy work, and never excludes a company that delivered failed systems. Time to clean the slate and get all new executive management and all new contractors. As for the permanent civil servants, as many of them who can be cleaned out the better. It is amazing that in a country which reveres its fighting force, we accept such shoddy claims systems and healthcare from a swollen, ill managed set of facilities and contractors.

Mon, May 5, 2014

At some point congress needs to quit asking the VA for things, they need to compel leaders to testify in front of them.

Thu, May 1, 2014 janette davis Louisville ky

I was injured in the Army when I fell about eight feet from a rope. I have been in pain since 1988. I have fibromyalgia degenerative joint disease facet arthritis Tendonitis and osteoarthritis among other issues caused by the fall. I have repeatedly filed for disabilty starting in 14999 after my diagnosis'. I was told records werr lost or missing. My case was transferredtwo atleast three different offices without my knowledge. I req uuntested changes in my dd214 and my gi bill monies were never returned and I told them with no results. I repeatedly appealed the va decisions. After dealing with them up to 2600100th I was sent a letter stating laws had changed and they were being forced to review my case. I didnt hear what the result of that was. I called the va repeatedly and left messages most of which were to answered. I requested records from y he military in 1999. I received some in 2009. I looked again through my things and found some more but not all of my medical records. I sent them all to the va repeatedly with no result. In 2013 after sending my records certified to the Louisville va I recieved a letter stating my case was again being reviewed. Just last week I recieved another letter stating my 1999 case was denied and closed and this is a new case. I also recieved a letter for appointments for the va .none which I completed today. This has been painful and emotionally and physically frustrating at the very least. I have spent a lot of money on copies and mail and traveling to the va. I was able to be treated at the va for two years until I was told I couldn't go there anymore because I got out in under two years ans they would only treat me for "personality disorder" which is what they basically pushed me out on while I was in extreme pain from mu injuries and also depression from having a mi as carriage and subsequent infection that was caused from the miscarriage and lack of a doc before I was sent into a combat zone while on restriction for my medical issues. This has been an awful experience that changed my life in a very negative way from the time I fell from that rope. Its been a shame at how I and so many other vets have been treated after serving our country and being honorably discharged. I am so disappointed in the system and feel I have been severely mistreated. Additionally today I was asked about my religion during the appointment. I think that falls under being illegal. If im not wrong.

Thu, May 1, 2014

When was the last time Eric Shinseki ever actually answered an IT type question congress asked of the VA? This might be a good time to call Steph Warren to congress and ask him to detail what's gong on. Congress need not hold their breath on this matter either.

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