Regardless of whether the Department of Veterans Affairs decides to keep or replace its EHR system, the medical system is going to need more funding to modernize VistA.
During a White House press briefing this week, VA Secretary David Shulkin listed out (PDF) 12 areas of focus for the VA moving forward, almost all of which could be solved by restructuring management practices and legislative changes rather than additional funding. President Donald Trump's budget includes $4.3 billion in additional funding for the VA in 2018.
“I do believe, with the excepting of one area, that we will not be coming back to Congress or the administration to ask for addition money,” he said. “That one exception is to modernize our IT systems.”
Shulkin said he still intends to make a decision about whether to entirely replace VistA with an off-the-shelf system or outsource the existing system before July 1. He again emphasized that he wants the VA to get “out of the software business,” but said that he will require additional funds regardless of which option he chooses.
“That will require an initial capital investment that’s not in our fiscal year budget,” he said, noting that the EHR upgrade is the most expensive task on the VA’s agenda.
VA officials have endured repeated criticism from lawmakers regarding the amount of money that has been invested into the agency’s in-house EHR solution, and several have acknowledged that the VA needs to move towards commercial solutions. Technical purists say VistA is still one of the premier EHR systems, but it has been mismanaged.
Last month, lawmakers pressed Shulkin to consider how the VA systems with interact with the Department of Defense, which began the rollout of a new commercial EHR system earlier this year.