DOD and VA consider an electronic health record czar

Watchdogs and lawmakers have frequently identified the lack of a single accountable authority as a potential weakness in efforts by the Departments of Defense and Veterans Affairs to implement a commercial electronic health record system based on Cerner's software.

Now leaders at VA and DOD are inching closer to a final governance plan to cover the projects – which together are expected to cost more than $20 billion.

James Byrne, acting deputy secretary at VA, said at a Feb. 5 Senate Appropriations hearing that a joint executive council with senior members from DOD and VA currently provides the decision-making function, but that a single point of accountability could be the answer in the future.

"All of us have agreed, despite any rumors that are out there, that we would like to consider the option… to have one arbitrator -- whatever the title -- a purple person -- who we all agree would make decisions where there's a dispute between the DOD and the VA," Byrne said.

There's no purple person lined up yet, Byrne said. But the joint council called for as part of a September 2018 deal between then-Defense Secretary James Mattis and VA Secretary Robert Wilkie is going to issue recommendations on a leadership structure by the end of the month.

Sen. Jon Tester (D-Mont.), who sits on the appropriations subcommittee that funds VA and is ranking member of the Veterans Affairs Committee, worried that VA's priorities could get lost in the overall management of the project, because of both DOD's size and its two-years head start on implementation.

"DOD can steamroll the VA," Tester said.

Sen. John Boozman (R-Ark.), the subcommittee chairman, pressed the point about VA and DOD rolling out their organizational and accountability structure for the interlinked modernization projects.

"We're going to push really hard to see that and if not you're going to have to come back here and explain why it's not being done," Boozman said.