Trump vows VA record sys­tem up­grade

Says sep­a­rate Pen­tagon net­work is in­com­pat­i­ble

The Washington Times Daily - - POLITICS - BY DAVE BOYER

The Trump ad­min­is­tra­tion an­nounced Mon­day that it is tak­ing a multi­bil­lion-dol­lar step to over­haul the Depart­ment of Vet­er­ans Af­fairs’ elec­tronic med­i­cal records sys­tem to make it com­pat­i­ble with the De­fense Depart­ment’s records.

“This is one of the big­gest wins for our vet­er­ans in decades,” Pres­i­dent Trump said at the White House.

VA Sec­re­tary David J. Shulkin an­nounced the move that’s in­tended to stream­line the agency’s health care for vet­er­ans by co­or­di­nat­ing their records with the Pen­tagon.

“I have de­cided that VA will adopt the same [elec­tronic health records] sys­tem as DoD,” Mr. Shulkin said. “It’s time to move for­ward.”

Mr. Trump said the use of two sep­a­rate sys­tems “has caused mas­sive prob­lems for our vet­er­ans.”

“We are fi­nally tak­ing steps to solve the sit­u­a­tion once and for all,” the pres­i­dent said.

Mr. Shulkin is is­su­ing a waiver on open bid­ding re­quire­ments due to “the ur­gency and the crit­i­cal na­ture of this de­ci­sion.” The move means that the VA can is­sue a so­lic­i­ta­tion di­rectly to Cerner Cor­po­ra­tion for ac­qui­si­tion of the EHR sys­tem cur­rently used by the De­fense Depart­ment.

Vet­er­ans likely won’t see changes for sev­eral years, with the soft­ware con­tract to be forged over the next six months, and the sys­tem’s cus­tom de­sign and im­ple­men­ta­tion to take much longer. Mr. Shulkin couldn’t es­ti­mate the even­tual cost but noted that the VA sys­tem will be big­ger and more com­plex than the Pen­tagon’s, which cost about $4.3 bil­lion.

The money isn’t in the VA’s cur­rent bud­get, and Mr. Shulkin said he’s al­ready be­gun talk­ing to House and Se­nate ap­pro­pri­a­tors about ad­di­tional fund­ing.

House Ap­pro­pri­a­tions Chair­man Rod­ney P. Frel­inghuy­sen, New Jersey Repub­li­can, said he has been push­ing for the up­grade for years.

“To avoid in­ter­rup­tions in care or ex­pen­sive re­dun­dancy, the Ap­pro­pri­a­tions Com­mit­tee has de­manded that the De­part­ments of Vet­er­ans Af­fairs and De­fense use an iden­ti­cal or at least com­pat­i­ble or in­ter­op­er­a­ble net­work,” Mr. Frel­inghuy­sen said. “Today, with his de­ci­sion, Sec­re­tary Shulkin con­firmed that the time for ac­tion has ar­rived.”

Rep. Charles W. Dent, Penn­syl­va­nia Repub­li­can and chair of the Ap­pro­pri­a­tions sub­com­mit­tee on Mil­i­tary Con­struc­tion/Vet­er­ans Af­fairs, said an integrated med­i­cal records sys­tem is a “bi­par­ti­san goal” in Congress.

“My fo­cus is to pro­vide the best care pos­si­ble for vet­er­ans, sup­ported by a mod­ern elec­tronic health record sys­tem that best serves their needs as they tran­si­tion from ac­tive to veteran sta­tus and pro­tects their per­sonal in­for­ma­tion in a cost-ef­fec­tive man­ner,” Mr. Dent said.

The VA has been long crit­i­cized for records and sched­ul­ing sys­tems that cause back­logs and long wait times for treat­ment.

In the 1970s the agency pi­o­neered the elec­tronic sys­tem known as VistA, which man­ages health care in­for­ma­tion for mil­lions of vet­er­ans at VA cen­ters and clin­ics across the coun­try.

But crit­ics say that VA of­fi­cials have failed to up­grade the sys­tem, lead­ing to con­sid­er­a­tion of a com­mer­cial provider.

Mr. Shulkin said VistA “is in need of ma­jor mod­ern­iza­tion to keep pace with the im­prove­ments in health in­for­ma­tion tech­nol­ogy and cy­ber­se­cu­rity.

“Soft­ware de­vel­op­ment is not a core com­pe­tency of VA,” he said. “I said re­cently to Congress that I was com­mit­ted to get­ting VA out of the soft­ware busi­ness, that I didn’t see re­main­ing in that busi­ness as ben­e­fit­ting vet­er­ans. And, be­cause of that, we’re mak­ing a

de­ci­sion to move to­wards a com­mer­cial off-the-shelf prod­uct.”

Con­cerned Vet­er­ans for Amer­ica Pol­icy Direc­tor Dan Cald­well said the de­ci­sion was long over­due for the Vet­er­ans Health Ad­min­is­tra­tion.

“The VA’s elec­tronic health record sys­tem is ob­so­lete and is a bar­rier to mak­ing the VHA a bet­ter-func­tion­ing health care sys­tem,” Mr. Cald­well said. “We com­mend Sec­re­tary Shulkin for fol­low­ing through on his prom­ise to mod­ern­ize in­for­ma­tion tech­nol­ogy at the VA, and we hope this new sys­tem is prop­erly im­ple­mented.”

Mr. Shulkin said the gov­ern­ment has spent hun­dreds of mil­lions of dol­lars to make the De­fense

Depart­ment’s and VA’s health records sys­tems more com­pat­i­ble, but he said many chal­lenges re­main.

“Seam­less care is fun­da­men­tally con­strained by ever-chang­ing in­for­ma­tion-shar­ing stan­dards, sep­a­rate chains of com­mand, com­plex gover­nance, sep­a­rate im­ple­men­ta­tion sched­ules” and other com­plex­i­ties, he said. “The bot­tom line is we still don’t have the abil­ity to trade in­for­ma­tion seam­lessly for our veteran pa­tients and seam­lessly ex­e­cute a shared plan of care with smooth hand­offs.”

He added, “With­out im­proved and con­sis­tently im­ple­mented na­tional in­ter­op­er­abil­ity stan­dards, VA and DoD will con­tinue to face sig­nif­i­cant chal­lenges if the de­part­ments re­main on two dif­fer­ent sys­tems.”


Pres­i­dent Trump wants to re­build Amer­ica’s in­fra­struc­ture and be­gan push­ing his plan, part of which is a pro­posal to pri­va­tize the air traf­fic con­trol sys­tem. He promised that it would in­clude up­grades that have lan­guished for a decade. He called the cur­rent sys­tem “an an­cient, bro­ken, an­ti­quated, hor­ri­ble sys­tem that doesn’t work.”


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