Lawmakers approve $260M for VistA modernization, but demand interoperability with DoD

The House Appropriations Committee, in a subcommittee markup of the fiscal year 2017 Military Construction and Veterans Affairs Appropriations Bill last week, approved $260 million for the modernization of the Veterans Information Systems and Technology Architecture (VistA) electronic health record, with a catch: the agency will not receive any funding until it certifies it is interoperable with the Department of Defense's EHR.

"I can't believe we're still talking about doing this," Rep. Hal Rogers (R-Ky.), committee chairman, said.

"We've been harping with both DoD and VA for years" to fix the issue, he added. "[A] veteran, having been injured on active duty, when he comes to a VA hospital ... can't access his records from DoD; that's unacceptable. It's insane."

The VA and DoD, of course, have been chastised frequently by Congress in recent years for their lack of EHR interoperability. Earlier this month, VA CIO LaVerne Council and David Shulkin, undersecretary for health at the Veterans Health Administration, touted progress made on the interoperability front with DoD to the same subcommittee, only to be told the process is taking too long.

What's more, in a House hearing last fall focusing on EHR interoperability, lawmakers called for "consequences and accountability" for poor performance and a lack of results. Rep. William Hurd (R-Texas) blamed poor management, and not technology, for the agencies' issues.

"The current plan for DoD and the VA to modernize their healthcare IT infrastructure in order to achieve full interoperability lacks metrics and goals," Hurd said in the October hearing. "These are not issues of data standardization; this is management 101."

Council repeatedly has floated the possibility that the VA could ultimately ditch VistA to procure an off-the-shelf EHR, similar to DoD's actions last summer.

At the bill markup last week, Rogers compared the ongoing process to walking through the mud.

"I hope beyond hope that we can make them speed that process [of interoperability] up," he said.

To learn more:
- watch the markup