VA to Pilot Health Records System in March 2020

Officials from the Veterans Affairs Department told House lawmakers Wednesday they expect to pilot initial operating capabilities of its new electronic health records platform in March 2020 across three sites in the Pacific Northwest.

It was welcome news for House appropriators who have already grown disillusioned with the cost and length of the project, as well as early hiccups less than one year into its development. Developed by Cerner Corp., the cost of the records overhaul stands at $10 billion over 10 years following a $350 million cost hike in November.  

“I think I feel better now than I did when we started this hearing,” said Rep. Will Hurd, R-Texas, following hours of testimony from VA officials before the House Appropriations subcommittee on Military Construction, Veterans Affairs and Related Agencies.

However, VA has a lot of work to do before any pilot of Cerner’s Millennium health records software could go live.

One of the major challenges underway involves mapping all 131 nationwide instances of Vista, VA’s current health records platform and getting the data into a format Cerner can view. The end goal is for VA to migrate all its health records data from all its systems to a single enterprisewide system that is interoperable with the Pentagon’s health records system and private health care providers. The Defense Department, meanwhile, has experienced its own major issues developing its new health records system with Cerner.

John Windom, executive director of VA’s Office of Electronic Health Record Modernization, told lawmakers that “22 data domains have been mapped” thus far, with 5 billion records “queued up and ready to be transferred.” Windom said “a data migration process has begun,” but could not say how long it took to map a single instance of VA’s old Vista-based records to Cerner’s platform.

“It’s a bit shocking that nobody knows how long that process took because the two complaints you’re going to hear are that it’s taking too long and it’s costing too much,” Hurd said.

Rep. Debbie Wasserman Schultz, D-Florida, flagged VA’s lack of steady leadership as a major concern. In one exchange, the subcommittee chairwoman asked VA General Counsel James Byrne how long it would take before the agency installs a permanent deputy secretary—a key position ultimately responsible for the health records rollout. Byrne is currently performing the duties of that role.

“Those decisions are up to the president and secretary,” Byrne said. “We all roll in and roll out, that’s why we put a major emphasis on the governance construct.”

Wasserman Schultz also probed officials regarding how they will ensure seamless interoperability between VA and the Defense Department despite security clearances required to view active duty or military records. If it is not reconciled, Wasserman Schultz said only VA clinicians with a security clearance could actually access military health records.

Windom said VA was “working through” the issue, but had not determined the proper solution.

Windom also told lawmakers he would be “cautiously aggressive” in how quickly VA tries to implement its solution. Regarding some milestones, Windom said VA purposely slowed things down, in part to ensure end-users are adequately prepared to use the new system.