DOD, VA officials defend progress in rare joint hearing

Amid criticism of deficient leadership, officials from the departments of Defense and Veterans Affairs on July 10 reiterated their commitment to an electronic health records-sharing program during a joint hearing between the House Armed Services and Veterans Affairs committees in Washington.

Leaders from DOD and the VA told lawmakers that plans remain on target for seamless sharing of troops' medical data between the two agencies by the end of this year. They also said the system will eliminate the use of wasteful paper-based records and eventually help expedite the claims process – a process that has created a backlog of outstanding benefits claims that the VA is laboring mightily to clear.

At the same time, DOD officials are moving forward with plans to solicit a new software-based healthcare management system, while the VA remains intent on modernizing its current Veterans Health Information Systems and Technology Architecture [VistA] system.

Frank Kendall, undersecretary of defense for acquisition, technology and logistics, told lawmakers that progress already is tangible and the agencies are on track for continued improvement, including near-term accelerated efforts to reach full interoperability by the end of the 2013 calendar year.

"We are currently talking to each other; I think there's a misconception about that. We are sending electronic records today, so in that sense we are talking to each other," Kendall said. "We want to have an improved system...so we're not just reading the records, we're actually using them and using that data that's provided. We also want to eliminate the paper part of the records that we're sending. We're moving very quickly to accomplish those two things."

However, lawmakers were unconvinced, asking questions about now-abandoned plans for a single, shared records-management system between the two agencies.

"We have spent hundreds of millions of dollars," said Rep. Mike Michaud (D-Maine), ranking member of the Veterans Affairs Committee. "Delaying the delivery of an integrated – that is integrated, not interoperable – information-sharing system runs directly against Congressional intent, and ultimately hurts our veterans."

Michaud was not the only one expressing doubts and frustration at the hearing.

"The only thing interoperable we get are the litany of excuses flying across both departments every year as to why it's taking so long to get this done," said House Veterans Affairs Committee Chairman Rep. Jeff Miller (R-Fla).

But officials insisted Congress is focusing too much on the system itself – something that is secondary to what is truly important, the capability to easily access share critical information.

"We have got to concentrate on the data-interoperability by the end of 2013 and rolling out in 2014. It's important to understand we'll always be an evolving system," said Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of TRICARE management activity. "It's got to be about data standards so that we can transfer information rather than what system someone is on, because we'll never get the entire nation to be on the same system but we do need to capture that data."

Eventually the integrated digital records are intended to streamline the entire records system, including the parts related to benefits claims processing at the VA. However, those advantages will not be immediate, officials admitted.

It also will not help reduce the claims backlog, said Danny Pummill, director of the VA's Veterans Benefits Administration. "It'd be wonderful for the future to have everybody in the government to be able to look at one medical record and be able to grab all their information'" he said. "The electronic health record, if that ever works out, would be great for the future but it would not help us in eliminating the current backlog."

The fiscal 2014 defense authorization bill includes an amendment ordering the integrated electronic health record program to be completed by Oct. 1, 2016. Officials speaking on the panel, including Kendall, expressed concerns about "constraints" in legislation such as certain deadlines and spending restrictions.

"Tying us to a strategic plan that was written last fall [and] that has been very much overcome by events by now is not particularly helpful," Kendall said. "That plan doesn't reflect some very fundamental changes we've made since it went into effect."

Miller, however, said he believes the legislation remains a key factor in keeping the agencies and their plans in check – and that he'll be monitoring progress closely.

"The message of the amendment is simple: No more excuses, get this done," Miller said in his opening statement. "I'm anxious to hear from our witnesses how they'll comply with the mandate of the amendment once it is enacted into law."