- On March 7, 2017 the Department of Veterans Affairs (VA) confirmed its decision to implement a commercial EHR system in place of previously unsuccessful attempts to construct a homegrown platform.
During a House Committee on Veterans Affairs hearing, a plan to modernize VA health information technology projects was addressed, including updating the federal agency’s EHR technology to existing off-the-shelf systems from outside vendors.
This decision comes after efforts to use a customized system developed by the VA itself have proven unreliable and too challenging to maintain.
In his written testimony, Secretary of Veterans Affairs David Shulkin, MD, outlined what future legislation guiding improvements in veteran community care should prioritize as objectives:
1.) Provide standardized, clear eligibility criteria for Veterans to get care closer to home.
2.) Facilitate building a high-performing network of community care providers, which has our Department of Defense, other Federal, and academic affiliate partners as the foundation, and reimburses for care using contemporary payment models.
3.) Better coordination of benefits for Veterans, allowing VA to work directly with third-party insurers.
Standardization and proper coordination of care have been problematic for VA in the past due to lackluster technology.
After failed projects such as VistA, an EHR system the federal agency attempted to build itself, VA officials are eager to implement a less labor-intensive, costly, and time-consuming EHR system more likely to deliver reliable patient care.
“The system was designed, and it was too complex and too difficult to maneuver,” Shulkin commented.
“I want the system to be modernized,” Shulkin added. “I believe veterans deserve the very best this country can offer—that means modern IT systems, modern facilities, modern types of programs, and professionals and technology.”
Similarly, members of the commission convened last month to highlight several issues with VistA barring VA from entering the modern era of EHR technology and care delivery. Some of the issues, happening alongside the rest of the healthcare industry, included limitations regarding interoperability and troubling past security problems.
With a new system, Shulkin intends to mitigate these issues by no longer funneling resources into solving problems with the ineffective technology in place. Instead VA will focus on shifting the federal agency’s strategy in approaching EHR system modernization entirely.
“I have 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 stated, “We need to move towards commercially tested products. If someone can explain to me why veterans benefit from being a good software developer, maybe I would change my mind. Right now we should focus on the things we need to focus on, and you will see that change in direction.”
In February’s hearing, Acting Assistant Secretary for Information Technology and CIO for the Office of Information and Technology at the VA Rob Thomas advocated for Cerner EHR and FHIR, reminding the commission FHIR is the industry interoperability standard allowing for the best chance at optimized health data exchange across providers.
“Last year, Dr. Shulkin as the Undersecretary of Health directed that we move forward with an Epic commercial solution,” Thomas stated, insinuating VA has been considering commercial EHR technology since at least January.
With a more definitive announcement to adopt commercial EHR technology in last week’s hearing, VA aims to solve issues with interoperability, expensive modifications and updates, and delayed care resulting in poor patient health outcomes caused partly by problems with VistA technology.