House seeks details on VA's health record push

House Republicans are seeking clarity and detail from the Department of Veterans Affairs on plans to improve the Veterans Health Information Systems and Technology Architecture electronic health record system and make it interoperable with a Department of Defense effort that is still in the planning stages.

The appropriations bill that funds the VA and military construction, which the House passed April 30 by a vote of 416-1, requires the agency to update Congress on progress to modernize VistA, since it decoupled its efforts to create an integrated health record from those at Defense in February 2013.

The two-year appropriation backs more than $3.8 billion for IT and about $550 million for systems modernization, but only 25 percent of the funding can be released until VA shares a development roadmap on VistA Evolution -- including any re-scoping, changes to cost estimates, testing plans and other efforts to ensure interoperability with the DoD system.

"The committee does not intend to delay the progress of developing the health record, but believes continuing oversight is necessary to ensure that the health record will have the capabilities and interoperability promised in the VA documents," appropriators wrote in their committee report on the bill.

Rep. John Culberson (R-Texas), chairman of the Appropriations subcommittee that funds VA, wrote in an April 30 op-ed that he expects similar language in the Defense authorization bill, requiring that Congress be kept in the loop on development of an electronics health records system at DOD.

The Obama administration is opposed to any delay in the release of money. While the administration is pleased with the funding levels in the bill, the Office of Management and Budget said in an emailed statement that "uncertainty in funding availability will delay needed enhancements for improved clinical decision support and better care for veterans."

"Significant steps toward improved interoperability have already been taken, including deployment of a joint legacy viewer to view patient records and improvement of data standardization between the Departments and patient identity management within both Departments," OMB said.

VA, meanwhile, is moving full steam ahead on the VistA Evolution plan. The department announced plans to use a public contest to solicit ideas for the revised health care record system in an April 25 notice published on the FedBizOpps.com website. The competition allows VA to solicit expert and academic input for its new technical architecture that it might not otherwise be able to obtain under contracting rules.

The news comes as the VA is planning to pitch VistA Evolution as a candidate to serve as the DoD's electronic health record system. Secretary Eric Shinseki announced those plans at a House Veterans Affairs Committee in March. At the same time, private sector players are gearing up to compete to serve as integrator on the $11 billion DOD contract. A final request for proposals is expected to be released sometime in May.