The House Committee on Veterans’ Affairs voted on Tuesday to pass legislation that streamlines and consolidates the VA’s community care programs, including establishing processes to improve information sharing with non-VA providers and ensuring safe opioid prescribing practices.
The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 requires the agency to implement a process to ensure that community care providers have access to available and relevant patient medical histories, such as a list of all prescribed medications.
Specifically, Section 131 mandates that contracted providers submit medical records of any care or services furnished—including records of any prescriptions for opioids—to VA in a timeframe and format specified by the agency.
“VA would be responsible for the recording of those prescriptions in the electronic health record and enable other monitoring of the prescription as outlined in the Opioid Safety Initiative,” states a committee summary of the VA MISSION Act.
Section 132 of the legislation calls for improving information sharing with community providers. This provision “would clarify that VA could share medical record information with non-department entities for the purpose of providing healthcare to patients.”
In addition, the VA MISSION Act calls for the agency’s participation in a national network of state-based prescription drug monitoring programs.
“Section 134 would allow any licensed healthcare 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,” according to the committee. “Under this authority, licensed healthcare providers or delegates would be required to query the network in accordance with applicable VA regulations and policies, and no state would be authorized to restrict the access of licensed healthcare providers or delegates from accessing that state’s prescription drug monitoring programs.”
The VA MISSION Act also provides for licensure of VA clinicians who provide treatment via telemedicine.
“Section 151 would create a new authority to allow VA healthcare professionals to practice telemedicine regardless of the location of the provider or patient during the treatment,” states the committee. “The section would also make clear that telemedicine does not need to be delivered in a federal facility. The section would also invoke federal supremacy regarding state telemedicine delivery laws and regulations to ensure uniform care delivery nationally. It would define a ‘covered healthcare professional’ as a VA employee who is authorized to furnish healthcare and is required to adhere to all quality standards relating to the provision of medicine in accordance with VA policies.”
The bill requires the VA to submit a report to Congress within one year of enactment, providing data on provider and patient satisfaction, the effect of telemedicine on patient wait-times, as well as healthcare utilization and other measures.
Another provision of the VA MISSON Act directs the agency to implement an information technology system to assess and improve the family caregiver program, which offers benefits for family members who care for severely injured post-9/11 veterans. “Section 162 would require VA to implement an information technology system that fully supports the Family Caregiver Program and allows for data assessment and comprehensive monitoring by not later than October 1, 2018.”
Further, Section 507 of the legislation calls for the establishment of a two-year medical scribe pilot program “under which VA will increase the use of medical scribes in emergency department and specialty care settings at 10 VA medical centers.”
Half of the participating medical scribes in the pilot are to be employed by the agency, with the other half employed through contract with a private sector provider of medical scribes. “Under this legislation, VA would be required to report to Congress every 180 days regarding the effects the pilot program has had on provider efficiency, patient satisfaction, average wait time, the number of patients seen per day and the amount of time required to train an employee to perform medical scribe functions under the pilot program,” states the committee.
In addition to the VA MISSION Act, the House committee on Tuesday also passed the Veterans’ Electronic Health Record Modernization Oversight Act, which provides for congressional oversight of the agency’s plans to replace its decades-old Veterans Health Information Systems and Technology Architecture (VistA) with a commercial-off-the-shelf EHR platform from Cerner.
“VA is currently in the final stages of its negotiations with Cerner for one of the largest contracts in VA’s history,” according to committee. The bill directs the agency 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” and “requires VA to notify Congress in the event of any significant cost increase, schedule delay, loss of veteran health data or breach of privacy.”
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