President-elect Barack Obama's choice to head the Veterans Affairs Department vowed during his Senate confirmation hearing on Wednesday to transform the sprawling agency into a 21st century organization that relies heavily on automated processes.
Retired Gen. Eric Shinseki, a former Army chief of staff, also told the panel that he would work with Defense Department Secretary Robert Gates to ensure development of a seamless electronic health record for active-duty personnel and veterans. Shinseki said the obstacle to developing the digital records was not technical but rooted in the leadership at VA and Defense, and if confirmed as VA secretary, he plans to discuss the matter with Gates.
Shinseki also said he wants to make VA's business practices as "paperless as possible" to streamline operations and support decision-making. He also promised that the department would not miss its deadline to start issuing checks under the new GI bill passed this summer. Shinseki said he intends VA to start sending payments to veterans by August, "with as few administrative problems as possible."
In an illustration of the problems Shinseki faces as he tries to make VA a paperless organization, outgoing VA Secretary James Peake told the House and Senate VA committees in a letter last October that the benefits payments the GI bill creates will require "significant manual processing" until the department can develop a claims processing system. VA has hired the Space and Naval Warfare Systems Command to build the system. Sources told Nextgov last week that SPAWAR only recently started work on the system, just seven months before the GI bill goes into effect. Sources added that VA has allocated minimal staff to the project and has not yet hired a contractor.
In their comments to Shinseki, three senators on the VA committee -- Jon Tester, D-Mont.; Kay Bailey Hutchinson, R-Texas; and Roger Wicker, R-Miss. -- put the onus on Defense for the slow development of an electronic medical record system that the Pentagon and VA can share
Tester said he was concerned that the two departments don't have a seamless record despite working on the project for a year. "We need to get Defense to buy into it," he said. Hutchinson said Defense had not matched VA's commitment to the project.
Shinseki told the panel the technology to build a seamless electronic health record "is there" and it is "just a matter of getting the technology to do the right handshake" between the electronic health record operated by Defense and the one operated by VA.
Wicker asked Shinseki if he thought a single electronic health record could meet the requirements of both departments. Shinseki said he could not answer the question at this time, but he reiterated his position that sharing medical information between the two departments was not a technical issue, and had to do instead with leadership.
A spokesman for the Military Health Systems said, "We look forward to working with Secretary Shinseki" on electronic health records.
Shinseki told the hearing that VA's VistA electronic health record system received an informal endorsement from doctors at the Walter Reed Army Medical Center in Washington when Shinseki had a checkup there last week. He said he asked two Walter Reed doctors if they were familiar with VA's electronic health record system, and, according to Shinseki, they said, "they thought it was an excellent system, and they wished they had it at Walter Reed."
Sen. Daniel Akaka, D-Hawaii, said he expected the full Senate to conform Shinseki on Jan. 20, Inauguration Day.