VA, DoD get tighter leash with iEHR cash

Congress puts forth stipulations to receive system funding
By Erin McCann
11:08 AM
Capitol building, Washington
Lawmakers on Capitol Hill again expressed concern over the botched development and higher-than-expected price tag of creating a seamlessly integrated electronic health record between the Departments of Defense and Veterans Affairs, ultimately tacking on project funding restrictions in the House's Omnibus Appropriations Act passed Wednesday afternoon.
 
"The actions of the Departments of Defense and Veterans Affairs in developing an electronic health record continue to be of concern to the Committees," the bill read. 
 
Original estimates for the iEHR were estimated to be between $4 billion and $6 billion. However, in September 2012, the Interagency Program Office doubled its previous estimates, pegging the final price tag somewhere between $8 billion and $12 billion. However, both estimates proved to be grossly inaccurate, as costs climbed to a whopping $28 billion early last year. 
 
 
In February, due to the lack of progress and the rising price tag, efforts to create an iEHR between both departments were scrapped. Instead, at least for the time being, DoD and VA will either work to improve their existing system or procure a new system independently. However, lawmakers emphasized that an iEHR between the two departments is still the end goal. 
 
"The Committees want to be very clear with both Departments: An interoperable record between the two Departments is the chief end-goal for Congress," House lawmakers said Wednesday. This "important project," they continued, "will end up being a futile exercise if the result is not the development of systems that will be interoperable." 
 
The Act appropriated some $252 million, which was originally budgeted to go toward iEHR development, to be split, with some $219 million being allocated to improving the VistA system and $33 million going to interoperability and the execution of the Virtual Lifetime Electronic Health Record Health. 
 
 
However, before the departments spend more than 25 percent of the funds, they "must be transparent" and present Congress with a detailed expenditure plan that outlines timelines, benchmarks, data standardization plan and interoperability testing. 
 
In a House subcommittee hearing back in May, Democratic Georgia Representative Sanford Bishop was among the group of lawmakers concerned over the iEHR's lack of progress. "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. 
 
Earlier last year, following bouts of fierce criticism from policymakers and prior to a Congressional hearing on the agency's iEHR progress, VA's then Chief Information Officer Roger Baker and Chief Technology Officer Peter Levin submitted their resignations. 
 
Other IT-related appropriations in the bill passed Wednesday include $4.6 million allocated toward ICD-10; $32 million for the Veterans Benefits Management System; and some $30 million set aside for other IT systems development.