On December 7th, the U.S. House Subcommittee on Information Technology held a hearing to examine VA IT systems, including FITARA performance, development of the new EHR system, and efforts to modernize its VistA system.
IT is crucial to the VA’s ability to serve the nation’s veterans. Each year, VA spends billions of dollars on IT to help fulfill its mission. In FY 2017, it spent approximately $4.4 billion on IT efforts. But the department has faced challenges acquiring, managing and modernizing IT over the last decade.
The subcommittee heard testimony from four VA IT executives, as well as Dave Powner, Director of IT and Management Issues at GAO. VA participants included Scott Blackburn, acting VA CIO; Dominic Cussatt, CISO; John Windom, PEO VA EHR Modernization; and Bill James, Deputy Asst. Sec. for VA’s EPMO.
At the hearing, senior VA officials confirmed the cost and timeline for the planned implementation of Cerner’s Millennium electronic health record system would be $10 billion over 10 years. With 332,586 VA users, 1,675 facilities and 102 legacy interfaces, this will be the largest implementation of an EHR in a health care system.
In June, Secretary Shulkin announced that VA would adopt the same EHR solution as DoD to capitalize on their existing efforts and build a seamless common system that goes beyond interoperability.
VA’s program executive in charge of the health record procurement, retired Navy captain John Windom, tried to put the project into perspective. VA has three times the number of beneficiaries, facilities and legacy interfaces as DoD, and the "complexity is four times larger" than what DoD faces in its implementation.
Windom said that they could not provide the subcommittee with cost breakdowns at the hearing, because the contract with Cerner has yet to be signed. VA is waiting on the House and Senate appropriations committees to approve a transfer of funds between VA accounts to provide them with necessary upfront funding for the project.
VA officials assured the committee that they will provide Congress with full transparency in this project, including an Initial Operating Capability milestone and other decision points prior to full deployment.
Dave Powner with GAO testified that VA has spent over $1.1 billion for contracts with 138 contractors during FY 2011 - FY 2016 for efforts to modernize VistA (iEHR and VistA Evolution programs). Powner stated that VA’s efforts to develop plans for the new EHR and to staff an organization to manage the program, follow project planning best practices. However, he expressed concern that the department is still early in its modernization planning efforts, and many are dependent on the contract award with Cerner, which has not yet occurred. The report GAO released to serve as Powner’s testimony stated, “The department’s continued dedication to completing and effectively executing the planning activities that it has identified will be essential to helping minimize program risks and guide this latest electronic health record modernization initiative to a successful outcome—one which VA, for almost two decades, has yet to achieve.”
On FITARA progress, VA officials said they are pleased with the latest score of a B+, but not satisfied. VA is seeking ways to improve upon that grade and raise the score to an “A.” One step VA is taking is the establishment of an OIT-based Strategic Sourcing division to ensure FITARA compliance for all IT acquisitions. Additionally, the IT Operations and Services (ITOPS) division continues its data center consolidation effort to merge and close data centers at VA facilities throughout the country. This year, they closed 23 data centers, and plan to close another 91 by the end of FY 2018.
GAO credited VA with achieving a respectable FITARA score, but expressed concerns over the data center consolidation aspect of FITARA. VA’s data center closure progress has fallen short of targets set by OMB. VA has also reported $23.61 million in data center-related cost savings, yet does not expect to realize further savings from additional closures.
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