House members push for more EHR interoperability

Lawmakers on the House Veterans Affairs Committee want to use the must-pass 2020 defense authorization bill to advance interoperability and joint management of the electronic health records systems at the Departments of Defense and Veterans Affairs.

DOD and VA both contracted to use software from commercial provider Cerner to remake their legacy health records systems. VA is replacing its homegrown Vista system through a $10 billion contract with Cerner. DOD, under a $5.4 billion contract with Leidos and Cerner, is already rolling out the Cerner-based system dubbed MHS Genesis to replace multiple legacy systems. MHS Genesis is live in multiple Pacific Northwest facilities and the next round of go-live dates is expected this fall.

One amendment offered by Rep. Susie Lee (D-Nev.), the chairwoman of the Subcommittee on Technology Modernization of the House Veterans Affairs Committee, looks to empower a planned joint DOD-VA management entity with authority over "functional, technical, and programmatic activities that are jointly used, carried out, and shared by the Departments." The amendment was co-sponsored by full committee chairman Rep. Mark Takano (D-Calif.) and ranking member Rep. Phil Roe (R-Tenn.)

Under Lee's amendment, the new office is tasked with developing and implementing a "comprehensive interoperability strategy" to make sure that information on DOD and VA records can be used across both departments in an integrated and comprehensive way, and can exchange information with systems used by community providers -- increasingly an option for patients in DOD and VA systems. The joint office will have contract writing authority and will have funds delegated to it by DOD and VA -- although how much is not yet specified in any legislation. 

An amendment from Rep. Conor Lamb (D-Pa.), also backed by Takano, Roe and Lee, would require the planned Federal Electronic Health Record Modernization (FEHRM) Program Office to contract with an outside group to confirm that DOD and VA have hit key interoperability benchmarks.

The push comes as lawmakers have complained that DOD and VA have been slow to charter the Federal FEHRM Program Office and name permanent leaders. DOD and VA are negotiating which department should lead the effort and whether joint governance should be about technology integration or focus more on clinical and policy matters.

In the meantime, VA and DOD are expected to name an interim director and deputy director to move ahead with joint management. FCW has learned that VA will name the interim director and DOD will name the interim deputy director, but both will have to agree on any new policy decisions.