VA, DoD on tighter leash with iEHR

Bipartisan bill holds iEHR money hostage
By Erin McCann
04:40 PM
Hal Rogers, R-Ky

Members of Congress are lauding a bipartisan bill that limits funding for an integrated electronic health record system between VA and DoD and requires aggressive progress updates from both agencies, which have, in recent months, come under fire for the dilatory pace at which they're moving forward with the iEHR. 

At a subcommittee mark-up hearing Wednesday, John Culberson, R-Texas, chairman of the House Subcommittee on Military Construction, Veterans Affairs and Related Agencies, called the bill a bipartisan success. "Our bill this year has dealt with the failure of DoD and VA to develop a single unified medical record in a very straightforward, commonsense way," he said. 
The bill, Culberson explained, will limit the funding toward the iEHR to 25 percent — of the $344 million requested. The agency will not receive the remaining dollars until they can prove to both agency subcommittees that they're actually implementing a plan to create and roll out a single, unified medical record. 
Just this February, VA Secretary Eric Shinseki and then DoD Secretary Leon Panetta announced that plans for a fully-integrated EHR between departments would be scrapped due to cost concerns.
Original estimates for the iEHR were pegged at $4 billion to $6 billion. However, in September 2012, the Interagency Program Office revised its previous estimates, figuring the final price tag to be from $8 billion to $12 billion. 
Following fierce criticism from policymakers and prior to a Congressional hearing on the agency's iEHR progress, VA Chief Information Officer Roger Baker and Chief Technology Officer Peter Levin submitted their resignations. 
Congressman Sanford Bishop, D-Ga., and ranking member of the House Subcommittee on Military Construction, Veterans Affairs, & Related Agencies, also expressed positive remarks toward the funding restrictions. "I'm very pleased," he said in the hearing. 
Two of his biggest frustrations, he added, have been over the delayed progress with both the VA claims backlog and the iEHR. "I find it very troubling that we can put a man on the moon, but we can't figure out how to figure out a joint, integrated electronic health record system," said Bishop. 
Congressman Hal Rogers, R-Ky., chairman of the Committee on Appropriations, also weighed in, calling the bill a "good example of bipartisan collaboration."
Rogers stated his "full agreement" with the bill's language on EHR requirements. "No longer will a veteran going to a veterans' hospital not be adequately served because VA can't get DOD medical records on that individual . . . that's inexcusable," Rogers said at the May 15 hearing. "When I first learned of that, I was actually aghast. Surprised and aghast that these two agencies of the government could not share information, particularly about the lives and health about individual soldiers who had sacrificed on the field of battle with injuries . . . we will not tolerate any more that kind of activity." 
Overall, the bill allocates $3.6 billion, plus reimbursements to VA information technology systems, one being the iEHR. 
The bill also rescinds money that was not spent on certain projects, or what Culberson called a "use it, or lose it" requirement. The bill rescinded $1.4 billion of the $43.6 billion in discretionary funding requested for VA medical services; $100 million in medical support and compliance funding; and $250 million in medical facilities funding. 
"Agressive monthly reporting" from each VA regional office will also now be required to give committee members a clear picture of the VA's progress on the disability claims backlog. 
The bill also denied funding for 10 additional military projects.