Lawmakers have offered several proposals to reform the Department of Veterans Affairs (VA) Electronic Health Records Modernization (EHRM) program, but VA officials and an official from the Government Accountability Office (GAO) expressed their opposition on April 19 to many of those bills during a House Veterans’ Affairs Committee legislative hearing.
Nevertheless, one House bill stood out by gaining wide support from the VA and GAO witnesses – presenting a possible solution for the EHRM program.
First, the bills that generated witness opposition at the hearing, and then one that witnesses embraced.
EHRM Program Termination Bill
One bill that received wide pushback from VA witnesses was the ‘Terminate the EHRM Program of the VA’ proposal, introduced in January by Rep. Matt Rosendale, R-Mont. As the name suggests, the bill aims to abolish the program and revert VA facilities where the new EHR is deployed back to the VistA system it replaced.
“VA opposes this bill as it would frustrate the VA’s ability to have an interoperable and longitudinal record with the Department of Defense,” said Phillip Christy, deputy executive director of VA’s Office of Acquisition, Logistics, and Construction.
“Modernizing VA’s EHR is critical for providing the best care for our veterans and facilitates advancements in the delivery of that care,” he added. “We believe terminating the program would work against those goals.”
Manage VA Act
Another proposal that witnesses opposed was the Manage VA Act – introduced last month by Rep. Mark Takano, D-Calif. – which aims to create an undersecretary for management, who would serve as the chief management officer (CMO) at the VA.
Rep. Takano, who serves as the ranking member of the House VA committee, said his bill would “consolidate acquisition and business functions at the department.” However, Shelby Oakley, director of contracting and national security acquisitions at GAO, warned that the VA must do more than establish a CMO position.
“Establishing a CMO position is not a solution on its own – it must be accompanied by other supporting organizational changes,” Oakley said in her written testimony.
“Our prior work illustrates potential challenges that efforts to establish a VA CMO may face and that Congress should consider as a part of any legislative direction to VA,” she added.
For example, Oakley said the VA would need to clearly define how the CMO would exercise its authorities and responsibilities in relation to senior officials who already oversee VA’s IT, acquisitions, and finances.
“VA has implemented robust governance to drive jointness and integration in support of the secretary and the deputy secretary, who serves as VA’s chief operating officer. This framework enables evidence-based, risk-informed decision-making that advances the mission of the VA,” Christy said.
“Currently, the assistant secretary for enterprise integration serves as the VA accountable executive for enterprise management and governance in support of the Office of the Secretary,” he added. “The VA already has in place many of the functions this bill prescribes.”
IT Modernization Improvement Act
Not all hope was lost at the legislative hearing, as the Department of Veterans Affairs IT Modernization Improvement Act, introduced by Rep. Takano, gained the support of the VA and GAO witnesses.
The bill is what Rep. Takano called “a short-term solution,” and would require the VA to contract for the independent verification and validation (IV&V) of certain modernization efforts of the department.
Christy said the VA supports the bill “if amended and with appropriations.” Ideally, he said the VA would have an in-house team with the expertise to conduct IV&V of its major modernization efforts – such as the EHRM program.
“Contracting IV&V support while VA builds internal capacity makes practical sense and will help expedite the resulting delivery of benefits to veterans, their caregivers, and family members,” Christy said. “VA anticipates an IV&V contract of this size would be extremely expensive – appropriate and timely funding of this bill is critical.”
“I don’t think it’s ever too late to do the right thing,” added Oakley. “Having a concerted IV&V effort for a program like EHRM as it continues to roll out, I think, is critically important to provide that good quality information to make those go/no-go decisions and the certifications that are outlined in the bill.”