After years of hand-wringing about its antiquated information technology systems, the Department of Veterans Affairs is poised to replace its legacy electronic health record system with a modern commercial EHR.

Appearing before a House committee last week, VA Secretary David Shulkin, MD, 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.

Although he did not mention the VA’s decades-old Veterans Health Information Systems and Technology Architecture (VistA) by name, the VA chief comments seemed to suggest that the agency would be moving to replace its legacy EHR with a commercial system.

“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 in his first congressional hearing since being confirmed as VA secretary.

“We need to move towards commercially tested products,” he added. “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 who know how to do this better than we do.”

David Shulkin

In response to Shulkin’s testimony, Randall Williamson, director of healthcare at the Government Accountability Office, agreed that the VA’s IT systems are critical to serving the needs of the country’s millions of veterans and desperately need outside help.

“Secretary Shulkin’s willingness to look at commercially available off-the-shelf systems is a really good move,” said Williamson. However, he emphasized that even with such a transition to commercial vendors, the VA “still has to integrate with legacy systems” such as VistA, “so it’s not a slam dunk,” Williamson concluded.

Last month, Rob Thomas, the VA’s acting CIO and assistant secretary for information and technology, acknowledged before a House committee hearing that VistA lacks the tools and advanced analytics capabilities of a modern commercial EHR.

Thomas even went so far as to say he was “confident” that the VA would be replacing VistA with a commercial EHR. “I can’t speak for Dr. Shulkin,” he added. “I hope for a speedy confirmation so that he can help us work through that.”

Also See: Top official casts doubt on future of VA’s legacy EHR

When it comes to the VA’s IT systems, Rep. Julia Brownley (D-Calif.) told Shulkin last week that, “It still feels like we’re driving a Model T down an L.A. freeway, trying to keep up with the Teslas and the BMWs.”

The VA secretary acknowledged that the agency needs to modernize its IT and that, without such modernization, the nation’s largest integrated healthcare system could become “non-competitive.”

At the same time, Shulkin boasted that the VA uses telehealth technology across the agency “on a scale that no other health system in America is even approaching,” with 2.1 million visits for more than 700,000 veterans who have access to healthcare via telemedicine services.

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