Congress presses VA secretary on VistA interoperability, costs

Shulkin reiterated his July deadline for choosing the path forward for the outdated EHR to the House Committee on Appropriations on Wednesday.
By Jessica Davis
01:52 PM
VA VistA David Shulkin

All options are still on the table for VistA’s future, including the adoption of an off-the-shelf EHR or working with a commercial vendor able to support the outdated EHR, Department of Veterans Affairs Secretary David Shulkin said Wednesday.

But one choice is cheaper than the other.

Shulkin told the U.S. House of Representatives Committee on Appropriations that the VA is considering a commercial off-the-shelf option, but if they opt to forgo working with an outside vendor to modernize VistA, the VA will need more funding to replace the system.

[Also: Open source experts to VA: Keep VistA, it can be fixed]

“We’re exploring all options,” Shulkin said. “The problems in the VA aren’t financial. These are systemic issues that haven’t modernized -- the IT system is one example.”

Also top-of-mind for the committee was EHR interoperability with the Department of Defense.

“It’s my understanding the DoD has already rolled out the system. In order to ensure interoperability… what’s wrong with the DoD’s system?” Rep. Nita M. Lowey (D-NY).

[Also: VA hospitals outperform mainstream facilities on readmissions, mortality rates]

Interoperability is a highly complicated issue for an agency the size of the VA. Since many veterans use private sector healthcare providers, the system needs to be interoperable with those systems as well, said Shulkin.

“If there was an easy solution, I’m sure it would have been made already,” said Shulkin. “[Congress] has asked DoD and VA to work together for 10 to 15 years, and we’ve always found ways not to. [DoD Secretary] Mattis and I believe we need to find ways to work together.”

The VA has learned the hard way and has taken far too long to make decisions. And the system has multiple flaws. Shulkin said he is open to all ideas and will take any path forward that works best for veterans.

“IT has to be a core competency of any organization nowadays,” said Shulkin. “We don’t want to be in the development business, but managing systems are a competency of any business.”

To best serve veterans, the VA needs to work with a core group of VA staff, while considering private sector accomplishments and apply that knowledge to the agency, said Shulkin.

“I’m only here for one reason, and it’s to solve the problems that have plagued VA,” he said.

Twitter: @JessieFDavis
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