- The Senate has passed a bill with provisions regarding the Department of Veterans Affairs (VA) EHR plans and health IT interoperability. The bill (HR 2029), comes in the wake of much discussion and debate about EHR interoperability between the Department of Defense (DoD) and VA.
The legislation includes language regarding EHRs at the VA, with specific provisions about Congressional funds for EHR development, the plans the VA must submit to receive further funds, and the definitions for interoperable use of EHRs.
In the clause regarding health IT, the Senate wrote that in order for Congress to permit funds for health IT development, executives from the VA must submit a budget proposal to both the House of Representatives and the Senate.
“That amounts made available for information technology systems development, modernization, and enhancement may not be obligated or expended until the Secretary of Veterans Affairs or the Chief Information Officer of the Department of Veterans Affairs submits to the Committees on Appropriations of both Houses of Congress a certification of the amounts, in parts or in full, to be obligated and expended for each development project,” the bill says.
Additionally, the VA must submit budget increase requests to both the House and the Senate before expanding the EHR project by more than $1 million.
“Provided further, That no project may be increased or decreased by more than $1,000,000 of cost prior to submitting a request to the Committees on Appropriations of both Houses of Congress to make the transfer and an approval is issued, or absent a response, a period of days has elapsed,” the Senate wrote in the bill.
Both provisions require the VA to submit plans for EHR and health IT implementation that include such items as the status of VA EHR implementation, changes to the breadth of EHR functionality, actual implementation costs, progress in meeting implementation deadlines, a Project Management Accountability System, progress in establishing EHR interoperability, and the tools needed to implement the EHR.
Additionally, the bill requires the VA to submit the interoperable functionality of the EHR:
“[T]he definition being used for interoperability between the electronic health record systems of the Department of Defense and the Department of Veterans Affairs, the metrics to measure the extent of interoperability, the milestones and timeline associated with achieving interoperability, and the baseline measurements associated with interoperability,” the bill says.
This bill comes during a time of significant EHR and interoperability debate between both the VA and the DoD.
After abandoning plans to create a joint, integrated EHR between both the VA and the DoD, the two agencies began efforts to implement their own individual EHRs still with the goal of interagency interoperability. The DoD plans to purchase a commercial EHR, while the VA plans to enhance its existing EHR system.
Within the past month, these EHR projects have proven to be a headache for government officials, with a recent hearing in the House of Representatives showing the lack of progress the agencies have made in implementing these systems.
During the hearing, members of the House Committee on Oversight and Government Reform expressed frustration toward the VA for not meeting its timelines for EHR implementation.
“I don’t mean to understate the enormity of the challenge of integrating the two largest federal bureaucracies,” said Congressman Will Hurd (R-TX), “but it’s clear to me that our inability to integrate these two systems is a failure of leadership rather than technical feasibility. This is not an issue of data standardization. This is management 101.”
As the VA’s EHR modernization efforts continue, this legislation will potentially help to streamline EHR projects to help create a sufficient and interoperable system in a timely and cost-effective manner.