The Department of Veterans Affairs is currently spending 75 percent of its information technology budget on maintenance to sustain the VA’s infrastructure of antiquated legacy systems that are crippling operations and are at risk of failing.

That was the sobering assessment VA Secretary David Shulkin, MD, detailed during a press briefing on Wednesday at the White House.

Currently, veterans are waiting 60 days or more for new appointments in primary care and mental health at 30 of the VA’s medical facilities nationwide, according to Shulkin, while more than 90,000 disability claims are taking more than 125 days to process. He blamed aging systems for the poor performance.

“Our scheduling systems and our financial systems are outdated, and that contributes to these excess wait times,” said Shulkin. “Both systems are in the process of being replaced, but it’s going to take years to complete that.” In addition, he revealed that 20 of the VA’s facilities have outdated systems for IT and inventory.

“That makes it very, very difficult for doctors and nurses to get the supplies that they need to care for veterans,” Shulkin said. “We’ve taken immediate steps to begin to start fixing these inventory systems, and we’re executing on those plans.”

David Shulkin

According to Shulkin, the VA has to modernize all of its IT systems to “make them commercially viable and cloud-based solutions to the maximum extent possible.” As a result, he said the agency will be “coming back to Congress or the Administration to ask them for additional money” for IT modernization—although, no specific dollar estimate has been suggested for the revamp.

Regarding the replacement of the VA’s legacy electronic health record system with a commercial EHR, Shulkin remains committed to making a decision by no later than July 1.

Last month, Shulkin told Congress that the agency is weighing several modernization options for its Veterans Health Information Systems and Technology Architecture (VistA) EHR system. A major challenge for the VA is that the agency maintains 130 unique VistA instances across the enterprise, making modernization and standardization efforts extremely complicated, expensive and time consuming.

Also See: VA narrowing options for modernizing its legacy EHR

The agency is “either going to look towards outsourcing our current system to a commercial vendor or picking a system that is a commercial off-the-shelf system, and to get VA out of the software business,” Shulkin concluded. “And, that will require an initial capital investment that’s not in the fiscal year budget.”

Testifying in March before a House committee, Shulkin told lawmakers that they will see a “change in direction” at the VA when it comes to the agency’s use of commercial-off-the-shelf software.

“I've come to the conclusion that VA building its own software products and doing its own software development inside is not a good way to pursue this,” Shulkin testified March 7 before the House Veterans’ Affairs Committee. “If somebody could explain to me why veterans benefit from VA being a good software developer, then maybe I’d change my mind. But, right now, we should focus on the things veterans need us to focus on and work with companies that know how to do this better than we do.”

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