When servicemembers transition to civilian status, they must deliver their medical records from the Department of Defense to the Department of Veterans Affairs. Currently, no solution exists to seamlessly transfer this information – a fact that has vexed both the Pentagon and the VA. Because the two medical systems are incompatible with one another, it's possible that important information gets lost in the shuffle.
To remedy this situation, the VA is now undertaking the largest transition to electronic health records ever attempted in the U.S. Its goal is to create a system compatible with the Pentagon's.
Creating a new EHR system: A process that's taken decades
Lawmakers have pressed both organizations to create compatible EHR systems since at least 2000, according to Military.com. The VA has attempted this process many times, but each trial ended in costly failure.
The latest attempt was an integrated electronic health record (iEHR) system known as the Veterans Information Systems and Technology Architecture Evolution, or VistA Evolution. However, a 2017 audit from the nonpartisan Government Accountability Office found the VA spent about $1.1 billion between 2011 and 2016 on this project.
Despite the significant investment, former VA Secretary Dr. David Shulkin determined VistA wasn't achieving its goals and needed replacement. Before he was removed by President Donald Trump, Shulkin began looking into off-the-shelf solutions, eventually settling on health information technology provider Cerner Corp. of Kansas City, Missouri.
Though Shulkin was never able to complete a deal with Cerner, his replacement, acting VA Secretary Robert Wilkie, awarded Cerner a 10-year, $10 billion contract. Additional costs could drive these expenses up to $16 billion.
Monitoring the EHR process
Such an expensive project requires immense oversight to ensure funds are being allocated efficiently – something members of Congress know all too well.
"As the department embarks on the nation's largest overhaul, it is critical that we ensure veterans and taxpayers are protected throughout the transition," said Chairman of the House Veterans' Affairs Committee Rep. Phil Roe, R-TN, in a statement, per Military.com. "I know how much potential there is for a project like this to be a costly disruption. Congress has a duty to conduct rigorous oversight every step of the way."
To maintain this efficiency and transparency, the House created the new Subcommittee on Technology Modernization. One of five such bodies within the House Veterans' Affairs Committee, this new group is tasked solely with overseeing the new EHR implementation.
It's not the only new group doing so, however. Now that the Cerner deal is in place, the DoD, the VA and the IPO are working to establish joint modernization governance bodies. These interdepartmental groups will improve interagency communication, promote sharing of resources and create a more collaborative decision-making process, according to EHR Intelligence.
"If successful, it will be one of the lynchpins of a more responsive, agile, and efficient VA," said Subcommittee on Technology Modernization Chairman Rep. Jim Banks, R-IN, per EHR Intelligence. "If mismanaged, I fear a daunting and disappointing setback."
Given the amount of money involved, along with a history of failed attempts, it's safe to say that many different parties concerned with veterans' affairs, the DoD and government spending will watch this EHR project closely as it develops. If successful, the new technology will give servicemembers and veterans piece of mind, as they can rest assured that their health records will remain complete as they transition.
