House Spending Panel Backs Joint Defense-VA Electronic Health Record

This story has been updated. 

The House Appropriations Committee on Tuesday solidly backed development of a single, joint electronic health record for the Defense and Veterans Affairs departments in its preliminary version of VA’s fiscal 2014 spending bill.

The committee provided $344 million in development funds for the integrated electronic health record in fiscal 2014, up $92 million from the $252 million VA requested. The money would come on the condition that no funds be expended on any electronic health record project unless it is an open architecture system that serves both Defense and VA.

Defense Secretary Chuck Hagel told a hearing of the House Appropriations Defense Subcommittee on April 17 that he had “deferred” planned Pentagon procurements for a new Defense electronic health record because, “I didn’t think we knew what the hell we were doing." Nextgov reported on April 9 that the Military Health System had scrapped plans to issue requests for proposals for commercial software to beef up its EHR.

Defense sought $204 million in procurement funds for the iEHR in 2014 and said it anticipated spending another $254 million on the project through 2018.

At the April hearing, Hagel said he had assumed personal responsibility for the iEHR and promised a decision within 30 days, which is this week.

President Obama in April 2009 called for a “unified lifetime electronic health record” to be shared by Defense and VA, but on Feb. 5, the top leadership of both departments agreed to forgo plans to build a new iEHR and instead pursue less expensive technologies to make their respective systems more interoperable.

On Feb. 28, Roger Baker, then the VA chief information officer, said the departments dropped their grand development plans because estimated costs had soared to $12 billion from earlier estimates of between $4 billion and $6 billion.

The House Appropriations Committee in its version of the fiscal 2014 VA spending bill said it will require Defense and VA to provide it with a defined iEHR budget and a timeline for deployment.

Language in the House bill also would require Hagel and VA Secretary Eric Shinseki to jointly certify in writing to the House and Senate Appropriations committees prior to using development funds that the proposed integrated electronic health record will be the sole electronic health record. The Government Accountability Office must confirm this.

VA pitched its decades old Veterans Health Information Systems and Technology Architecture to Defense as an EHR candidate on Feb 27, and last Wednesday the VA notified vendors it needed to re-compete technical support and maintenance of VistA.

VA awarded Hewlett-Packard a 10-year VistA technical support contract valued at $784 million in March 2004. That deal hits its limit next March. Vendors, who declined to be identified, told Nextgov the new VistA support contract could be a key vehicle for the future iEHR, depending on whether or not Defense decides to go with the VA system.