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VA asks for quick funding fix to start 10-year medical records overhaul

Leo Shane III | Military Times

Veterans Affairs officials say it will take 10 years to fully match their electronic medical records with the military’s system, but they need nearly $800 million by the end of the year or else risk taking even longer.

That rush was met with skepticism from House appropriators on Wednesday, who noted that billions have already been invested in the department’s records modernization efforts with mixed results.

“The number of years and dollars wasted in reaching this point is unsettling,” said Rep. Charlie Dent, R-Pa., chairman of the appropriations panel’s Veterans Affairs subcommittee.

At issue is VA’s decision this summer to shift veterans’ electronic medical records to the same system used by the Defense Department, potentially ending a decades-old rift in information sharing between the two bureaucracies.

White House officials hailed the move at the time as bringing common sense to federal operations and simplifying lifelong medical care for members of the military. VA officials are currently negotiating contract details with Missouri-based Cerner Corp., which signed a similar deal with defense officials in 2015 to work on the MHS GENESIS records system.

The Pentagon deal is expected to cost at least $4.3 billion. Initial roll out of the new system began this year.

VA Secretary David Shulkin told lawmakers on Wednesday that in order to keep pace with that military work — and create some cost savings — his department needs to move ahead with parts of the work before the end of the year. That means reprogramming $782 million in other department funds for the work, a request VA officials filed last month.

“There’s enough blame on both sides with the Defense Department and VA for how we got to this point,” he said. “From my perspective, maintaining the status quo is not acceptable.”

The move is designed to ease information sharing between military medical centers and VA doctors.

Shulkin also said he had hoped Congress would adopt the fiscal 2018 budget for his department by now, giving VA planners the funds they need to move ahead.

But congressional budget talks are stalled until at least after the Thanksgiving break. And since the reprogramming request does not include the full Cerner contract cost — expected to exceed the Defense Department total — or new plans for a new office to oversee the work, lawmakers said they worry about spending more money on an incomplete strategy.

“Years down the road, I hope not to be at another hearing where we are talking about how we still have less than complete interoperability with VA and defense records,” said Rep. Debbie Wasserman Schultz, D-Fla., ranking member on the veterans panel.

Several lawmakers noted that six years ago “in this very room,” VA and Pentagon officials pledged to work together on a joint electronic medical records system only to abandon the idea two years later. Concerns over the record sharing issue date back to President Bill Clinton’s administration, with numerous partial fixes and missteps along the way.

Shulkin insisted the latest move will eventually end that ongoing saga.

He noted that modernizing the existing VA VistA system would cost about $19 billion over the next decade and provide less interoperability with military records than the proposed Cerner contract. He also recommended breaking the project into a separate funding account to provide easier oversight and transparency into the work.

“There is no doubt we are being aggressive, but we are also doing business differently,” Shulkin said. “We are committed to working with DOD and the private sector in ways we never have before. … As we’re setting this up, I don’t think this will be subject to political whims anymore.”

Schultz said she remains wary: “I look forward to being surprised.”

If the funding issue is settled by the end of the year, the first test sites for the new VA electronic medical records are expected to go online within 18 months.