In a long awaited and highly-anticipated move, the Department of Veterans Affairs (VA) will abandon its existing Veterans Information Systems and Technology Architecture (VistA). Moving forward, it will instead utilize a commercial, off-the-shelf electronic health record (EHR). The next-generation system will be the same platform the Department of Defense uses—a variation of the MHS GENESIS with data hosted on a shared Cerner Millennium system. This switch will allow for seamless integration and information sharing between the two systems, as well community partners and academic organizations.
“I said recently to Congress that I was committed to getting VA out of the software business, that I didn’t see remaining in that business as benefitting Veterans,” said VA Secretary David Shulkin in a statement announcing the move earlier this week. “And, because of that, we’re making a decision to move towards a commercial off-the-shelf product.”
The decision to move to a commercial system is not surprising considering Shulkin’s past scrutiny of the legacy systems and the exorbitant costs, upwards of $4 billion (roughly 75% of the VA IT budget), to keep them operational.
It’s not the first time the VA’s IT infrastructure has come under serious review. A 2015 report from the VA inspector general found that the department spent $1.3 billion to render its electronic claims system only “partially effective,” which resulted in a 120 percent increase over the initial budget to streamline the claims process. The $720 million price jump was due in large part to inadequate cost controls, unplanned changes to the system requirements, and inefficient contracting practices according to the report.
Not surprisingly, the report concluded the system didn’t meet the standards of fully functioning application. These past and current discrepancies in legacy infrastructure underscore the need by the VA to institute larger changes and IT modernization, cut costs, and improve operational efficiency, thus driving the move away from a homegrown system.
However, uncertainty modernizing the VA’s IT infrastructure lay ahead. The VA will need more money for IT modernization than what is proposed in the administration’s budget request for fiscal 2018.
While the VA is one of the few civilian agencies that that could receive additional funding, a $4.4 billion increase from 2017, it won’t be related to technology. The current budget proposal includes cutting millions of dollars to IT spending and does not address funding for the transition to a commercial system.
EHR modernization “will require an initial capital investment that’s not in fiscal year budget,” Shulkin said in a recent White House press briefing, signaling he will likely seek additional funding from Congress or the administration.
While many problems facing the VA could be categorized as managerial or legislative, Shulkin reaffirmed legacy systems are a major challenge and emphasized the need for funding IT modernization, listing several problems related to the aging systems, which, if fail, would devastate operations.
“We have to modernize all of our IT systems to make them commercially viable and cloud-based solutions to the maximum extent possible,” said Shulkin.
Not modernizing the VA’s outdated systems could pose major setbacks for not only VA staff, but also disproportionately hurt the veterans it’s intended to serve. Most notably, Shulkin highlighted the outdated VA Loan Electronic Reporting Interface (VALERI) system.
“Without funding for a new system, VA is going to have to revert to a paper-based, manual system for loans that are going to reduce the number of veterans that we serve, from 90,000 per year to only 12,000 per year,” Shulkin stated. Adding, “We can’t afford to let that happen, because veterans could be at risk of foreclosure or even homelessness, and that’s a risk that we’ve identified.”
About the Author
Alex Tzavellas serves as Practice Marketing Manager where he supports MIL’s cloud solutions marketing and sales efforts. He specializes in developing and executing strategies for federal and non-profit clients.