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VA EHR Interoperability Still Lagging, Senate Hearing Finds

House Appropriations committee members displayed frustrations at the Department of Veterans Affairs in a recent hearing, specifically with regard to its lagging EHR interoperability.

By Sara Heath

- Despite recent advances in EHR interoperability, the Department of Veterans Affairs is still not far enough along in its EHR modernization efforts.


In a Military Construction, Veterans Affairs, and Related Agencies subcommittee hearing, Senate leaders expressed frustration with VA’s lack of progress with its VistA EHR.

Senators Mark Kirk and Jon Tester lamented the agency’s lack of interoperability, expressing frustrations that the agency could not share a complete view of a patient’s health record. Because VA cannot exchange diagnostic images like x-rays or CT scans, the senators argued, providers could not see a full view of patient health and could not provide the highest quality of care.

Further, Kirk and Tester expressed dismay at VA’s lack of EHR progress in comparison to private technology vendors.

Many of the industry’s biggest names in the EHR business are developing predictive analytics tools, which can do things like predict likelihoods of suicides. Veteran suicide is a major concern for the VA, Kirk said, disappointed that the VA’s technology didn’t have these predictive analytics capabilities.

 Overall, Kirk, Tester, and other members of the subcommittee, questioned VA leaders on when they expected full interoperability.

In one witness testimony, the Government Accountability Office’s (GAO’s) Valerie C. Melvin sought to shed some light on VA’s timeline.

“In speaking about this matter, VA’s Under Secretary for Health has asserted that the department will follow through on its plans to complete the VistA Evolution program in fiscal year 2018,” Melvin reported in her testimony.

“However, the Chief Information Officer has also indicated that the department is taking a step back in reconsidering how best to meet its electronic health record system needs beyond fiscal year 2018. As such, VA’s approach to addressing its electronic health record system needs remains uncertain.”

Because of this uncertain future for VA interoperability, Melvin said the agency must consider important questions and reassess their timeline’s benchmarks.

“A modernized VA electronic health record system that is fully interoperable with DOD’s system is still years away,” Melvin said. “Thus, important questions remain about when VA intends to define the extent of interoperability it needs to provide the highest possible quality of care to its patients, as well as how and when the department intends to achieve this extent of interoperability with DOD.”

For their part, VA shared its progress in a testimony from LaVerne H. Council, CIO at the VA.

In her testimony, Council explained the strides the agency has made in recent years, explaining that it had certified to the 2014 National Defense Authorization Act interoperability standards.

Going forward, the agency plans to continue its interoperability efforts. While its Joint Legacy Viewer, a read-only display of patient health information, is fully interoperable with the DoD, VA is looking to the future with its Enterprise Health Management Platform (EHMP).

“eHMP will overcome [JLV’s] limitations, and provide a modern web application and clinical data services platform to support Veteran-centric, team-based, quality driven care,” Council explained. “eHMP will also natively support interoperability between VA, DoD and community health partners.”

In a second iteration of eHMP, which the agency is planning on rolling out in the second quarter of 2017, will allow providers to write notes and order labs or radiology tests. eHMP will also support care coordination and team-based care.

“Fundamentally, our efforts to improve information systems are about data, not software. Regardless of the software platform, we need to be able to access the right data at the right time,” Council concluded.

“Health data interoperability with DoD and network providers is important— but it is equally important to understand that this is just one aspect of having a comprehensive profile to streamline and unify the Veteran experience.”

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