House committee appropriates $1.6B for VA EHR in FY 2020
House appropriators on Thursday approved the Fiscal Year 2020 Military Construction, Veterans Affairs and Related Agencies bill, including $1.6 billion for the VA’s new Cerner electronic health record system.
The legislation, passed by the House Appropriations Committee, funds the VA, Department of Defense and other related agencies.
“After at least a decade of congressional encouragement to DoD and VA to develop a single electronic health record, VA has completed a contract to acquire the same EHR that DoD is adopting,” states the committee’s report. “The bill includes $1,603,000,000 for the EHR contract entered in 2018, and continues strict quarterly reporting of timelines, performance milestones, costs, implementation and change management.”
Of the $1.6 billion appropriated to continue implementation of the Cerner system, the legislation provides $1,106,500,000 for the electronic health record contract, $161,800,000 for program management and $334,700,000 for infrastructure support.
In addition, the committee’s bill continues the requirement for the Government Accountability Office to review the VA’ s EHR modernization implementation—which is currently estimated to cost a total of $16.1 billion—so that Congress “can be informed of any problems at a point where they can be promptly and economically addressed.”
Not surprisingly, members of Congress are insisting on strong oversight of the VA’s acquisition of the Cerner system in light of its hefty overall price tag and 10-year deployment schedule.
The VA’s acquisition program seeks to “develop an interoperable electronic health record system that will access seamlessly the records of veterans in the VA system and those of the Department of Defense and of community providers,” according to the bill.
Lawmakers noted in their legislation that the VA system is planned to be rolled out with the same timeline and geographic areas as DoD in order to realize cost efficiency savings.
The committee urged the VA to “explore and invest in modern, software-defined networking and hybrid cloud technologies to ensure that its EHR modernization network and IT infrastructure will effectively support the Cerner implementation and its subsequent use.”
The committee also said that it supports veterans having “real-time, seamless and portable access” to their medical records, and it urges VA to develop, as part of EHR modernization, “the means by which veterans can have secure, portable access to their own medical records.”
In addition, House appropriators encouraged the VA to “ensure the new EHR initiative provides an open architecture that allows a governance and oversight process for administering access and support to deploy third-party applications, components and application programming interfaces to ensure longevity of the EHR platform and requests information on the EHR modernization architecture be included in quarterly reports.”
At the same time, the committee said that it is “concerned about the pace at which implementation of cybersecurity best practices are occurring at the department, especially as VA and DoD continue to integrate electronic health information.” As a result, legislators urged the VA to “ensure that patient records being transferred from DoD to VA have the same level of security and data-level protections as provided by DoD.”
The committee also indicated that it is “concerned about the significant amount of time clinicians spend on the current electronic health record documentation in their treatment of veterans, as well as their inability to easily incorporate such information from within the veterans’ continuum of care, particularly the community care environment.”
Lawmakers pointed out that the “VA’s ongoing efforts with EHR modernization and interoperability with the Department of Defense provide an opportunity to assess innovative technologies’ ability to solve this challenge.”