VA’s Billion-Dollar Health Records Project Will Be Tracked by New House Subcommittee

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Lawmakers worry the department’s lack of leadership and hiccups in Defense’s rollout of its MHS Genesis platform could derail the $16 billion project.

House lawmakers see 99 problems ahead for the Veteran Affairs Department’s electronic health records rollout, but oversight ain't one.

House Veterans’ Affairs Chairman Phil Roe, R-Tenn., and ranking member Tim Walz, D-Minn., announced a new subcommittee to provide oversight for the department’s technology modernization projects, including the multibillion-dollar effort to get the department on the same commercial electronic health records platform as the Pentagon.

More details will come after the full committee’s business meeting July 12, but Roe said the subcommittee will likely consist of three to five members who will intensely focus on the EHR implementation.

“We’re on the team with you,” Roe told VA, DOD and Cerner officials at a Tuesday hearing about the project. “We’re not here to fuss at you, we’re here to make you successful.”

Veterans Affairs has tried to overhaul its EHR system before, wasting $1.1 billion in six years on failed projects. This time, the department signed a 10-year contract worth up to $10 billion with Cerner Corp. for a platform that can seamlessly share patient records between VA facilities, the Defense Department and community care providers. It expects to spend another almost $6 billion on infrastructure upgrades.

VA Acting Secretary Peter O’Rourke testified the department plans for an incremental, flexible implementation overseen by a properly staffed program management office and five functional governance boards. From July through September, the department expects to assess and validate initial operating capabilities at a handful of sites. In October, the EHR rollout will begin with full operating capability slated for March 2020. In the meantime, other legacy systems, such as VistA, will continue operating, he said.

Walz and Rep. Mark Takano, D-Calif., grilled O’Rourke about the department’s many leadership vacancies that could cause problems during such a massive project. Robert Wilkie, President Donald Trump’s nominee for secretary, is scheduled for a confirmation hearing Wednesday, but the roles of deputy secretary and undersecretary for health remain unfilled. O’Rourke told lawmakers department commissions had selected three different candidates for the undersecretary role but they weren’t selected. Takano pressed O’Rourke to get the position filled.

Roe said the department’s acting Chief Information Officer Camilo Sandoval wasn’t invited to the hearing, but a few lawmakers brought up his absence. Sandoval faces a $25 million lawsuit for sexual discrimination and workplace harassment from when he worked on Trump’s presidential campaign, according to Politico. Rep. Ann Kuster, D-N.H., pressed O’Rourke on whether Sandoval was around to do his job and what happens if he ends up losing it.

O’Rourke said Sandoval has his full confidence and has been restructuring the Office of Information Technology.

“If the president decides to remove a political appointee, then we will have somebody else step in to that role just like he stepped into the role when somebody else left,” he said.  

GAO Director of IT Operations Dave Powner testified an agency CIO’s involvement in large-scale projects often help ensure success and for this project, support from the Executive Office of the President and the federal CIO could also help.

Lawmakers also had concerns about the rollout Defense’s electronic health records systems, MHS Genesis, when the department’s own testing in April declared the system was “neither operationally effective nor operationally suitable.”

Vice Adm. Raquel Bono, director of the Defense Health Agency, told lawmakers the biggest challenges MHS Genesis faces are governance and change management, lessons Defense passes on to its Veterans Affairs counterparts.

The departments have an interagency working group that meets formally for day-long sessions about once a month and has standing Friday calls, John Windom, Veterans Affairs’ program executive officer for the EHR Modernization Program told lawmakers. They also are in constant contact with clinicians working in the field, he said.

“We’re all behind you,” Rep. Bruce Poliquin, R-Maine, said. “But we’re going to hold your feet to the fire.”