Congress to Defense and VA: Give Us a Plan for Integrating Health Records by February

The Defense and Veterans Affairs Departments will need to present a detailed plan for developing a single or interoperable electronic health record in just six weeks, based on language contained in the 2014 National Defense Authorization Act agreed to by the House and Senate Wednesday.

The two departments abandoned efforts to develop a single EHR in February when the  estimated costs of a system reached $28 billion. The 2014 authorization bill emphasizes interoperability based on computable data rather than a single record.

The bill requires Defense and VA to provide Congress “with a detailed plan for the oversight and execution of the interoperable electronic health records with an integrated display of data, or a single electronic health record,” by Jan. 31, 2014.

The EHR should feature “an integrated display of data” and should be based on national standards to allow the exchange of data with private health care providers, the bill said.

The bill requires the leaderless Interagency Program Office to identify the national standards and develop architectural guidelines, but it also added another level of bureaucracy, requiring the office to collaborate with the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services.

Tom Munnecke, who helped develop VA’s Veterans Health Information Systems and Technology Architectures and advocates that Defense adopt VistA to create a single EHR for both departments, said the NDAA language adds “levels of complexity to a problem that VistA has solved for 35 years.”

The bill also requires Defense and VA to adopt the new electronic health record by 2016. In October, the Pentagon estimated that it would not be able to deploy a modernized EHR until 2017.

An industry source said the language in the 2014 NDAA supports Defense in its pursuit of its own, rather than joint record with the VA, something the House Appropriations Committee mandated in May. The issue will not be resolved until final passage of 2014 spending bills.

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