The House Appropriations Committee has finally put its foot down after months of the military hemming and hawing over plans for an electronic health record that would serve both the Department of Defense and the Veterans Affairs health system. In its preliminary version of the 2014 Military Construction and Veterans Affairs spending bill, the House apportions $334 million in funding to “jumpstart” an integrated DoD-VA EHR. The funding will only be released after both departments certify that there will only be one single, joint EHR to serve both sides of the equation.
Congress has become increasingly frustrated with the mismanagement of billions of dollars that have been spent on feasibility reports and preparations for a joint iEHR that hasn’t materialized. After an abrupt turnaround in February, with then-DoD Secretary Leon Panetta and VA Secretary Eric Shinseki stating that they would instead develop separate core systems to save money, a hearing on the surprise announcement exposed significant failures in both departments. In response, the Pentagon recently took the drastic step of removing budgetary control of the project from the Military Health System, placing the funds under the watchful eye of Frank Kendall, Under Secretary of Defense for acquisitions, technology, and logistics.
The House Appropriations Committee decided on Tuesday that they will provide the new round of funding under several strict conditions: no funds are to be spent on anything other than a unified EHR, the architecture must be open and standards-based, and newly-installed DoD Secretary Chuck Hagel and VA Secretary Shinseki must commit to writing that the EHR developed with the money will be the only one created and used. That statement will need to be confirmed by the Government Accountability Office (GAO).
Secretary Hagel has taken personal responsibility for the DoD’s failure to handle the project effectively, and has vowed that his department “will do better” after not knowing “what the hell we were doing” for some time. The DoD has abandoned plans to issue proposal requests for commercial alternatives to the VA’s established VistA EHR, but has not yet accepted the VA’s suggestion to adopt VistA as their core system, too.