Lawmakers press Shulkin on VistA overhaul, push for better coordination with DOD

VA Secretary David Shulkin said the VA should be proud of VistA, but "frankly, that's old history."

It seems lawmakers are just as eager as the rest of the health IT community to find out the fate of VistA, the Department of Veterans Affairs' much-maligned EHR system.

During a hearing on Wednesday, members of the House Appropriations Military Construction and Veterans Affairs Subcommittee wasted no time grilling VA Secretary David Shulkin, M.D., about where he stands in deciding whether to keep VistA or replace it with a commercial solution. Despite their prodding, Shulkin offered little more about his decision-making process, other than to say he may need additional financial support from Congress if the VA elects to transition to a commercial system.

RELATED: Shulkin sets summer deadline for VistA decision, tempers expectations of switch to commercial EHR

Shulkin has set a July 1 deadline to determine the fate of VistA and repeatedly said the VA needs to get out of the business of software development. He reiterated that position to subcommittee members, while acknowledging that the agency has failed to align its medical records system with the Department of Defense.

“When I come out in July, I’m going to be talking about a process that led to a decision to get us out of the software development business and find a way to work even closer with the DOD than we have,” he said.

RELATED: DOD’s new EHR system looks to standardize care, improve interoperability

The DOD recently launched its new EHR system in February at Fairchild Airforce Base in Washington, which was built through a contract awarded to Cerner and Leidos. Several subcommittee members highlighted the disconnect between the DOD and the VA, including Rep. Nina Lowey, D-N.Y., who wondered why the VA wouldn’t explore the DOD’s system “from the outset” to ensure interoperability.

Rep. Thomas Rooney, R-Fla., asked Shulkin specifically if he would switch to the DOD’s system to improve care coordination.

“You could be the best VA secretary of all time if you just solve this one problem,” Rooney said.

“Anyone that has a better idea that I have, I’m going to take it,” Shulkin responded. He also noted the VA also must consider how it’s system will interact with community providers and private sector hospitals where veterans often seek care.

RELATED: EHR users see Cerner as the favorite to replace VistA

Based on two requests for information submitted by the VA last month, the agency appears to be considering two options for VistA: Replace the system in its entirety or contract with a commercial provider to supplement VistA’s capabilities. Either way, it seems the VA’s previous approach of building in-house systems is in the rearview.

“VistA is something VA should be proud of; it invented it and was the leader in electronic health records, but frankly that’s old history,” he said. “We have to look at keeping up and modernizing the system.”

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