Hagel Takes Personal Responsibility for Electronic Health Records

Defense Secretary Chuck Hagel has said he is personally taking responsibility for resolving problems that have plagued the exchange of electronic health records between Defense and the Veterans Affairs Department.

President Obama in April 2009 called for a “unified lifetime electronic health record” to be shared by Defense and VA; an  apologetic Hagel told a Tuesday hearing of the House Appropriations Defense Subcommittee that he could not justify the lack of progress since then.

“I can’t sit here and defend what we have done,” Hagel said in response to a series of questions from Rep. Nita Lowey, D-N.Y., about the integrated electronic health record that was all but scrapped by the two departments in February in favor of interoperable but separate systems. “I am going to acknowledge we are way behind,” he said.

Lowey said she was outraged by lack of progress on the iEHR project, which has cost $1 billion over the past five years. “We will do better,” Hagel said. “I have personally taken this on.”

Defense and VA have taken conflicting paths toward an iEHR this year. On Feb. 8, the Pentagon issued a request to vendors for assistance in developing a new electronic health record “with the most capability in the shortest period of time for the least cost.” VA responded to that notice with a pitch that Defense adopt its decades-old Veterans Health Information Systems and Technology Architecture --or VistA--system.

VA continued to back the iEHR concept, allocating half its requested 2014 information technology budget to the iEHR, which a VA spokesman told Nextgov “demonstrates just how committed the two departments are to delivering a single, joint, common integrated electronic health record.”

Lowey asked Hagel, “Is VistA being considered?” by Defense. Hagel did not answer that question directly, saying instead that he was committed to what the President called for in 2009: development of a seamless interoperable system. "I want it to work,” he added.

In an indication of his hands-on management of the health records issue, Hagel told the hearing that in late March he “deferred” a request for proposals for a new Defense EHR. “I didn’t think we knew what the hell we were doing," he explained. Nextgov reported on April 9 that the Military Health System had scrapped plans to issue RFPs for commercial software to beef up its EHR.

“Until I get my arms around this, we are not going to spend any more money on it,” Hagel told the hearing, referring to a new EHR. He added that he had restructured the management of the project with an individual in his office he did not identify with oversight.

Hagel promised progress “shortly” on the iEHR. “Can I tell you in a week or two? We will have something decided within 30 days, I’ll tell you that,” he said.