Long-Term Prognosis for VistA Uncertain

Published: March 16, 2016

Electronic Health RecordHealth CareHealth ITVA

During a House Appropriations Committee hearing earlier this month, VA CIO LaVerne Council announced that VA is reevaluating VistA (Veterans Information Systems and Technology Architecture) as their long-term electronic health record (EHR) solution of choice.

Council, who took over the post of CIO at VA in July of last year, wants to put in place a long-term plan for health records at VA.  She stated that this was not done before her appointment and is necessary in order to be a good stewards of millions of taxpayer dollars.  “The fact is we need to ensure we have laid out the plan and strategy so that everyone can understand exactly what we’re doing and why we’re doing it,” she said.

Lawmakers were surprised and disturbed by the news which continues the ongoing DOD/VA EHR saga which started as far back as 1998.  As recently as 2014, VA’s confidence in VistA was so strong that they offered it up as a solution for DOD’s efforts to replace its current EHR.  

Rep. Hal Rogers (R-KY) House Appropriations Committee Chairman said, “We’ve been at this for 10 years and we’ve given you billions of dollars.”

DoD and VA started an effort in 1998 to share electronic patient health information.  In 2011, they launched a program to develop a single common electronic health record system (iEHR).  The new system was to be implemented across both departments by 2017.  However in February 2013, both departments publically announced they were abandoning efforts to jointly develop a single EHR, due to new cost estimates of $12 billion versus original estimates of $4-$6 billion.  Instead, the departments would acquire, implement, or update their own EHRs, but achieve full interoperability among the two separate systems.  DoD and VA claimed that the new interoperability approach would be more cost effective to achieve the same goals of sharing patient data.

During the recent hearing, Council stated that VA’s needs have changed over the past few years. “There are multiple needs that are different than in 2014 around the area of women’s health, the Internet of things and how we manage private sector care,” she told the committee. 

Council assured the committee that money spent to date has not been wasteful, that DOD and VA have hit EHR interoperability goals and will continue to enhance interoperability functionality.  “The interoperability is about the data,” Council said. “We’ll continue to build on JLV and our enterprise health management platform, which is what we’re using to pull data from the Do record and align their data with ours as an integrated grouping so that our data is fully interoperable. By the end of this month, we’ll have well over 35,000 users and well ahead of our goal.”

Her intent is to develop an EHR strategy and plan that can serve as a long-term foundation for VA and help them better serve veterans and their care providers. “It’s not going to stop anything that’s currently being done, none of that’s being done in a wasteful manner, but we’re going to lay things out in a manner that allows Congress to see exactly what OIT is spending their dollars on,” Council stated.

VA requested $40 million less for VistA modernization in its 2017 IT budget than what was originally slated two years ago in order to be able to reevaluation the platform. 

Council did not state when the VistA study would be completed.