Chairman Roe: Modern IT Systems Are Essential at VA
Yesterday, the House Committee on Veterans’ Affairs, chaired by Rep. Phil Roe, M.D., held a hearing to examine the major Information Technology (IT) modernization projects and programs underway at the Department of Veterans Affairs.
Following the hearing, Chairman Roe and Ranking Member Tim Walz sent a letter to the Department of Veterans Affairs requesting that the VA provide the committee with quarterly status reports on major IT projects. The letter also asks for clarification of VA’s testimony regarding the Digital Health Platform and the department’s ongoing scheduling projects.
You can read the full text of the letter here:
You can watch Chairman Roe's opening remarks from yesterday's hearing here:
Opening Remarks As Prepared for Delivery:
We begin the 115th Congress examining IT because it is so important to everything VA does and everything we all hope to accomplish as part of the department’s transformation. From delivering timely care to veterans, to ensuring that medical records follow the patient, to making benefits decisions accurately, modern IT systems are essential.
This year and next are pivotal because the Department has major decisions to make about how to modernize its systems.VA is also beginning several projects they have attempted with poor results in the past, and now is the last chance to get them right.
Let’s start with VistA, the electronic health records system that performs so many other administrative functions. The Choice Act Independent Assessment in 2015 was an invaluable study of VistA. It explained the weaknesses and complexities that have accumulated in the system over the last twenty years and recommended that VA send Congress a comprehensive cost-benefit analysis of keeping VistA or changing course.
Then in 2016, the Commission on Care recommended VA retire VistA in favor of commercial-off-the-shelf software. However, the VistA Evolution program was already well underway when these recommendations were issued. VistA Evolution attempts to catch the system up and put it on a stable course for the future. It is the third major attempt to modernize VistA in the past decade. Retaining or replacing VistA is a make-or-break decision for VA and must be made deliberatively and objectively.
While the Department provided some cost-benefit analysis before and after the Independent Assessment, it was never as thorough as intended. Senior officials have testified to this Committee, and said elsewhere, that they accept the Commission on Care recommendation. But what that means in practice has become less and less clear. VistA Evolution is now in its fourth of five years, and I understand the desire to finish it.VA must judge it realistically against concrete goals. If it falls short, moving the goal posts is unacceptable.
Another key system is the Electronic Health Management Platform, or EHMP, which is also part of VistA Evolution and due next year. This is supposed to settle the medical record interoperability issue with DOD once and for all. After changing course so many times over the years and then putting an interim solution in place, VA has a great deal riding on EHMP. I look forward to hearing about the plan to finish it.
VHA also still badly needs a modern scheduling system, and both sides of the aisle are united to make sure it finally gets done this year. The Faster Care for Veterans Act puts commercial self-scheduling software in competition with VA’s VistA self-scheduling project and sets high standards for them both. If either one cannot meet the standards it must be eliminated.
VA announced in the media that the VistA project, called VAR, would be rolled out in January. Since that did not occur, the Committee would like to know what happened. Rounding out the list, last year this Committee highlighted upgrades to the system used to process community providers’ claims that had not been implemented. There has been some progress but the situation is far from perfect.
Similarly, the Veterans Benefits Management System has advanced at great cost, but still cannot handle appeals or all types of claims. Further, after two previous attempts, VA is again trying to replace its antiquated financial systems. This time the plan is to adopt an existing system used by the Agriculture Department rather than build it.
That is very encouraging, but it is a complicated, delicate project. Congress recognizes the depth of the technology needed by VA. To that end, we have increased the IT appropriation more than 7% on average throughout the last five years. All of these programs, and others we will address today, must use tax dollars responsibly. That is why the Inspector General report released last week on the failed cloud services broker contracts is so troubling. Unnecessary data centers are a big problem that devour VA’s budget. These contracts were an effort to push the Department into the cloud and make headway in consolidating the data centers.
But $5.3 million was wasted and nothing useful was produced. That $5.3 million could pay for so many other things, for instance 70 entry-level nurses in Johnson City, Tennessee. Every account in the budget affects every other account, and we have to start thinking that way.