The Department of Veterans Affairs has delayed deploying its new electronic health record (EHR) pilot until this July, VA Secretary Robert Wilkie told Congress on Thursday.
"That is my goal. I'm confident that we can fulfill our mandate," Wilkie said during a House Veterans Affairs Committee hearing on the VA's proposed 2021 budget. "I would hope that it would be earlier."
Among other benefits, the EHR is meant to relieve new veterans from having to physically carry around a copy of their treatment record by transferring their files electronically from the Pentagon to the VA. It would also combine the VA's health record programs so staff can spend more time with patients.
Two weeks ago, the VA postponed staff training on the EHR, which was set to go live in Spokane, Washington, by March 2020.
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"Two weeks ago was always the date that I'd chosen to make sure we would be ready," Wilkie said. "But I was not satisfied. And I promised you and [House Veterans Affairs Committee Chairman Phil Roe] that, if I was not satisfied, we would not launch."
Richard Stone, Veterans Health Administration executive in charge, said the EHR delay is a development issue.
"There are about a thousand work processes that need to be written," he said. "Those are substantially completed, but once you finish those work processes, you've got to set that electronic medical record into a number of interfaces that plug into the rest of the system. There are 73 interfaces; 19 are completed as of today, and that is why we're delayed."
He added that deploying the new EHR pilot system as planned would have eliminated Spokane veterans' abilities to refill prescriptions online. Currently, those veterans fill prescriptions about 11,000 times a month online, but since this part of the pilot is not operational yet, the VA would have had to set up a call center and input it all manually, Stone said.
While lawmakers and veteran service organizations expressed disappointment with the delay, they largely supported the VA's decision. However, Rep. Jim Banks, R-Indiana, asked VA officials to elaborate on the department's nearly doubled EHR budget request of $2.6 billion for fiscal 2021.
"I absolutely support the $90 million increase to accelerate the implementation of the scheduling system," he said, "but I have a hard time seeing how VA could even spend an $850 million increase for infrastructure and upgrades."
Stone said aging VA facilities need new cables, in addition to updating the heating and cooling system for the equipment, before the EHR can be rolled out to those locations in 2021.
"The greatest challenge -- and Dr. Stone touched on it -- is ancient buildings," Wilkie said. "I'm spending millions and millions of dollars building closets right now to house equipment because the facilities, some of which are a 100 years old or older, can't accept the kind of infrastructure that we need to get these programs online."
The new EHR system will include a new appointment scheduling system, which is expected to be rolled out first. The VA has been under intense scrutiny over the last five years as reports revealed some veterans had died while they waited for an appointment and one clinic had created a secret list to hide how long patients were waiting for care.
Jon Rychalski, VA assistant secretary for management and chief financial officer, listed one successful technological upgrade in Spokane. "They were able to change login times from something like 30 minutes to something like 15 seconds. I mean, it's really that significant."
Committee Chairman Mark Takano, D-California, reminded Wilkie that, while Congress wants the VA to get the new EHR right, lawmakers must be kept in the loop.
Wilkie acknowledged that responsibility and said he's been grateful for all the support lawmakers on the House VA committee have given him.
"You have graciously recognized the complexity of this program," Wilkie said. "It is the most complex program the federal government has undertaken, and you have given me gracious opportunities and great leeway to fulfill your mandate."
-- Dorothy Mills-Gregg can be reached at firstname.lastname@example.org. Follow her on Twitter at @DMillsGregg.
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