House VA Subcommittee Ranking Members Ask VA and IG to Address Electronic Medical Record Contract Delay and Reports of Inappropriate Outside Interference
Washington, D.C. – Today, House Veterans’ Affairs Subcommittee on Oversight and Investigations Ranking Member Annie Kuster (D-NH) and Subcommittee on Health Ranking Member Julia Brownley (D-CA) requested that the Acting Secretary of the U.S. Department of Veterans Affairs and the VA Inspector General investigate continued delays in finalizing a contract to implement a new VA electronic health record (EHR) system.
These requests follow a recent report in Politico on numerous instances when personal friends of President Trump — who have no official role within the VA and who may have undisclosed conflicts of interest — have interfered with and undermined the Department’s acquisition of a new EHR system. According to these reports, this interference has “effectively delayed the agreement for months.”
Kuster and Brownley have requested that Acting Secretary Robert Wilkie provide the House Veterans’ Affairs Committee with information on the status of the contract and that VA Inspector General Michael J. Missal investigate the report of inappropriate influence on the process by outside individuals. Kuster and Brownley were joined by Reps. Mark Takano (D-CA) and J. Luis Correa (D-CA) in signing both letters.
“The outdated and obsolete electronic health records (EHR) system used by the Department of Veterans Affairs desperately needs to be overhauled to improve care and services for veterans in New Hampshire and across the country,” said Kuster. “I’m disturbed by reports that individuals without any role at the VA may have hampered efforts to move forward with reforms that would update VA’s EHR system and allow full interoperability with the Department of Defense and community providers. These delays are unacceptable and we need to know what has caused them and how they will be resolved. Our veterans deserve seamless health care from the VA and its partners, and that goal simply cannot happen when the VA is using systems designed decades ago. We owe it to our veterans to ensure that the VA is operating at the highest possible level.”
“A new electronic health record system — that better connects with DOD health records — is imperative for improving care for our country’s veterans,” said Brownley. “Any delay in implementation is simply unacceptable, especially one that has been caused by inappropriate interference by personal friends of the President, whose qualifications and conflicts of interest are unclear. Caring for our veterans is too important to allow this to continue.”
The full text of the letters and PDF copies are available below.
May 2, 2018
The Honorable Robert Wilkie
U.S. Department of Veterans Affairs
810 Vermont Avenue NW
Washington, D.C. 20420
Dear Acting Secretary Wilkie:
We write with concern regarding the U.S. Department of Veterans Affairs (VA) continued delays in finalizing a contract with Cerner Corporation to implement a new commercial, off-the-shelf (COTS) electronic health record (EHR) that is fully interoperable with the U.S. Department of Defense. On April 30, 2018, Politico reported numerous instances of unofficial advisors to the President who have become involved in negotiations for VA’s EHR. Politico alleged that these unofficial advisors “effectively delayed the agreement for months.”
As you know, former VA Secretary David Shulkin instituted a pause in contract negotiations with Cerner Corp. pending completion of an independent assessment by MITRE Corporation. That assessment was intended to provide an analysis of Cerner’s ability to effectively implement an interoperable EHR and to assist VA in developing a contract with Cerner that would ensure VA’s multi-billion dollar investment actually improved the delivery of veterans’ healthcare at the VA. VA reportedly received MITRE’s assessment and 51 recommendations on or about February 12, 2018. On March 15, 2018, VA updated their solicitation to reflect recommendations provided by MITRE.
Unfortunately, it has been over two months since VA received MITRE Corp’s assessment and recommendations. While we were encouraged to see VA update their solicitation, the allegations reported by Politico are serious and compel us to request additional information on the following:
1. An explanation for VA’s inability to execute a contract with Cerner between receipt of the MITRE assessment and former Secretary Shulkin’s dismissal.
2. VA’s analysis of the 51 recommendations provided by MITRE and whether VA disagreed with any of the recommendations.
a. If VA disagreed with a recommendation, please provide a detailed explanation for the disagreement.
3. A detailed list of recommendations incorporated in the March 15th solicitation update.
4. A timeline of meetings between VA officials and Cerner since receipt of MITRE’s assessment, including meeting participants and a brief summary of topics covered at each meeting.
5. Remaining actions VA plans to take prior to executing a contract with Cerner, including an analysis as to why VA may believe those actions need to be completed prior to completing a contract with Cerner.
6. Any concerns identified by the Office of General Counsel in executing a contract prior to the confirmation of a Secretary to replace former Secretary Shulkin.
Modernization of the Department’s electronic health record is a shared priority between the VA and Congress. We are committed to preventing unnecessary delays such as those reported by Politico from hindering implementation of a modern EHR for the VA. The 9 million veterans enrolled in the VA deserve effective and efficient delivery of healthcare and a modern EHR is an important reform needed to accomplish that mission.
Thank you for consideration of our request.
May 2, 2018
The Honorable Michael J. Missal
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
Dear Inspector General Missal,
We write to request the Inspector General’s office investigate attempts by outside, non-governmental individuals to influence the Department of Veterans Affairs (VA)’s transition to a commercial off-the-shelf electronic health records (EHR) system. On April 30, 2018, Politico reported numerous instances of unofficial advisors to the President attempting to undermine the VA’s acquisition of a new EHR. The report also alleges that this interference has “effectively delayed the agreement for months.”
The modernization of the VA’s health Information Technology (IT) infrastructure is one of the most critical initiatives for the future of VA healthcare. Limitations in the capacity of the VA’s existing IT systems, especially the lack of system interoperability, is one of the key reasons that the U.S. Government Accountability Office (GAO) has placed VA healthcare on its High-Risk List. The VA has repeatedly failed to upgrade its electronic health record and its roughly 30-year-old outpatient scheduling system. For more than a decade, the VA and the Department of Defense have lacked an effective, efficient manner of exchanging patient health information through an EHR system. Former Secretary Shulkin’s commitment to modernizing VA’s IT infrastructure was supported by Members of Congress on both sides of the aisle in order to better deliver care to veterans.
Simply put, updating the VA’s EHR is too important to the health and wellbeing of the 9 million veterans enrolled in VA healthcare for the process to be stymied by interference from outside political forces. The process must be completely transparent and accountable, while ensuring the highest standards of patient care and responsible use of taxpayer resources. We are concerned that unofficial, non-governmental advisors who are not required to disclose potential conflicts of interest may be exerting unaccountable influence over this process.
As such, we request an investigation into whether non-governmental individuals have improperly attempted to impact the work of the VA’s Office of Information and Technology in this matter. Thank you for your consideration of this request.