VA cost estimates to maintain, update health record system from the 70s 'unreliable'

Photo credit U.S. Air Force photo by Walter Santos

The Department of Veterans Affairs is in the midst of a $16 billion overhaul of its electronic health records system, but during the 10-year endeavor, the agency must continue to maintain its costly existing program. VA leadership however doesn’t know how much maintaining the current electronic health records system costs, according to the Government Accountability Office. 

Lawmakers at a House Veterans Affairs Committee hearing expressed doubt about VA’s cost estimates, timelines and transparency, but said they hope for improvements. The system is supposed to go live for veterans on March 2020. 

The new program is intended to create a unilateral computer system that will handle universal health records. From the moment a person enters the Armed Services, they will have one electronic health record (EHR) that follows them their entire lives, including as they transition out of the service and begin seeking care at the VA or with private healthcare.

The original VA system was developed in the 1970s, and VA has “struggled to modernize since,” Rep. Susie Lee, D-N.V., said. 

“What began as a guerilla IT project has sprawled into a massive, decentralized system in an archaic coding language,” she said, adding that the current system “surpassed its technology lifespan” but “past attempts to replace (the system) have not been successful.” 

Rep. Jim Banks, R-Ind., said Congress had “yet to receive a satisfactory answer” on the details of total cost for the electronic health records transition and maintaining the legacy system until the new on is in place. 

Carol Harris, of the Government Accountability Office, told lawmakers that VA said it spent $2.3 billion maintaining the old system in 2015-17. But Harris said VA could only provide accurate documentation for about $1.3 billion of it. Many of the costs were “omitted” or unaccounted for, she said. When asked, Harris told lawmakers that the total cost to maintain the system was likely larger than the $2.3 billion, since VA did not include costs such as infrastructure and personnel. 

VA information technology “fiscal discipline has been evolving over time … we’ve been on a trajectory to try to improve it over time,” said Paul Tibbits, of VA’s IT office, adding that VA had “so far not seen the need to track personnel cost” in the total amount of money spent on the system.”

Tibbit told Congress that the VA agreed with GAO’s report and planned to comply with recommendations for better oversight of costs. 

But a lingering problem remains the joint oversight of the program between VA and the Department of Defense, which plan to both use the new system to create an easier transition for service member health records from active duty to veteran status. 

“I don’t think we have any confidence in (the cost),” Lee said. “And the lack of plan on joint governance continues to be a problem. Our lack of knowledge of what the plans are continues to concern us … (There are) billions and billions of dollars of cost of this project and I have concern and hope we can continue to have transparency, given the track record that we’ve had trying to update the system multiple times in the past.” 

Lawmakers doubt VA and DOD will meet deadline for universal health records

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Follow Abbie Bennett, @AbbieRBennett.