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Senator Criticizes Cuts to VA Health IT Infrastructure Budget

Proposed budget cuts to IT projects could undercut healthcare IT infrastructure modernization requirements of the Department of Veterans Affairs, a key senator is warning.

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By Fred Donovan

- Proposed budget cuts to IT projects could undercut healthcare IT infrastructure modernization requirements of the Department of Veterans Affairs, a key senator is warning.

In a Jan. 11 letter sent to recently confirmed Veterans Affairs (VA) Assistant Secretary of Information and Technology and Chief Information Officer James Gfrerer, Sen. Jon Tester (D-MT), ranking Democrat on the Senate Veterans’ Affairs Committee, said that “drastic cuts” in the VA’s IT budget proposed by the Trump administration for fiscal years 2018 and 2019 could prevent the VA from carrying out needed healthcare IT infrastructure investment.

The senator noted that the FY2018 budget requested $215 million less for IT spending than the FY2017 level and the FY2019 budget requested $100 million less than FY2017.

“A Budget Request that reflects the accurate needs of the Department, in addition to the resources needed for the Electronic Health Record Modernization project, is essential if VA is to carry out the health care and benefit priorities that Congress has established,” he wrote.

“VA cannot continue to operate in a technology environment in which only the largest and latest crisis drives the agenda,” Tester quipped.

The senator called on Gfrerer to ensure that the VA does not repeat past mistakes in implementing the new EHR system. The newly created Office of Electronic Health Record Management has responsibility for the implementation.

Last August, Genevieve Morris resigned her role as Interim Chief Health Information Officer for the OEHRM, saying that she decided to leave only weeks after her appointment because the project was going “in a different direction” than she had anticipated.

In 2017, the VA signed a $10 billion, ten-year contract with Cerner Corporation to replace its EHR system and resolve long-term interoperability concerns.

The decade-long EHR implementation will require the VA’s Office of Information and Technology (OI&T) to manage the IT infrastructure needs for both the facilities that have received the new EHR and those that have not. This will require significant resources and robust oversight, Tester said.

“Throughout implementation, OI&T must also go behind simply maintaining its current EHR system, VistA, and continue important development projects that allow VA medical centers to continue serving veterans without any adverse impacts. EHR modernization cannot be allowed to fail, and your leadership is essential if VA is to ultimately achieve a truly interoperable electronic health record for veterans,” he said.

The VA also needs to invest in updates to HRSmart and Veterans Benefits Management System programs, changes to the VA Schedule for Rating Disabilities, deployment of the Financial Management Business Transformation effort, and overhaul of the appeals process, which will require long-term investment in IT resources, he noted.

“Additionally, Congress passed a long-anticipated expansion of the Caregiver Assistance Program last year. It is my understanding that CareT, the new IT system being developed to support the Caregiver Program, may not be able to support the current or expanded Program,” Tester wrote.

“This could ultimately force the Department to purchase a Commercial off-the-shelf system and delay expansion of the Caregiver benefit. Such an outcome would be unacceptable to veterans, their families and caregivers, and Congress,” he warned.

Tester asked Gfrerer to provide him with a comprehensive and prioritized list of VA IT projects, including metrics or explanation of processes used to prioritize the projects. He also wanted to know if the VA CIO planned to reevaluate the process his department uses for IT project management.

“In my role as Ranking Member of the Senate Veterans Affairs Committee, I am eager to work with you to solve the litany of problems we have seen from OI&T, and I genuinely believe that we can do so. However, any progress towards achieving this goal is dependent on transparency from VA about the Department’s true IT needs and the challenges you face in funding and execution. On behalf of our nation’s veterans, I wish you and VA’s dedicated staff the best of luck as you begin your work,” Tester concluded.

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