WASHINGTON – U.S. Senators Johnny Isakson, R-Ga., chairman of the Senate Committee on Veterans’ Affairs, John McCain, R-Ariz., chairman of the Senate Armed Services Committee, and Jerry Moran, R-Kan., chairman of the Senate Appropriations Subcommittee on Veterans Affairs, sent a letter to Department of Veterans Affairs (VA) Secretary David Shulkin and Department of Defense (DOD) Secretary James Mattis praising the VA’s recent announcement that it will transition to the same electronic health record system as the defense department.

In their letter, the trio highlighted the “importance of effective, efficient, and integrated health systems” and encouraged the two departments to work together as the VA makes the transition to ensure our service members receive seamless and high-quality health care.

“To remedy historical failures in sharing medical records information, Secretary Shulkin announced that the Department of Veteran Affairs would procure the same electronic health record platform as the Department of Defense to maximize continuity of medical care for service members transitioning to veteran status,” the senators wrote. “We commend you both for your bold leadership in this area, and are looking forward to more initiatives between the DOD and the VA to share assets and coordinate efforts related to caring for our service members and veterans.”

“We remain optimistic about the VA’s electronic health record transition; however … we implore the VA to work with DOD’s experts to adopt any lessons learned and best practices from DOD’s recent experience with electronic health record implementation,” the senators continued.

As chairmen of two committees and a subcommittee tasked with overseeing the VA and the Pentagon, the senators also requested a detailed response from Secretary Shulkin and Secretary Mattis regarding the expected timeline for implementation as well what steps are being taken to prevent unnecessary hiccups during the transition.

The full text of the letter is below and available online here.

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June 26, 2017

The Honorable David J. Shulkin

Secretary of Veterans Affairs

U.S. Department of Veterans Affairs

810 Vermont Avenue NW

Washington, DC 20420

The Honorable James N. Mattis

Secretary of Defense

U.S. Department of Defense

1000 Defense Pentagon

Washington, DC 20301

Dear Secretary Shulkin and Secretary Mattis, 

As Secretary Shulkin recently stated, “VA and DoD have worked together for many years to advance [Electronic Health Records] EHR interoperability between their many separate applications at the cost of several hundred millions of dollars. …The bottom line is we still don’t have the ability to trade information seamlessly.” To remedy historical failures in sharing medical records information, Secretary Shulkin announced that the Department of Veteran Affairs (VA) would procure the same electronic health record (EHR) platform as the Department of Defense (DOD) to maximize continuity of medical care for service members transitioning to veteran status. We commend you both for your bold leadership in this area, and are looking forward to more initiatives between the DOD and the VA to share assets and coordinate efforts related to caring for our service members and veterans. The importance of effective, efficient, and integrated health systems cannot be overstated.

Recently, major federal IT infrastructure upgrades and overhauls have not had overwhelming success. We remain optimistic about the VA’s EHR transition; however, we hold great concern that the scope of this project brings several risks related to excess costs and implementation delays. We implore the VA to work with DOD’s experts to adopt any lessons learned and best practices from DOD’s recent experience with Military Health System (MHS) Genesis implementation. We cannot afford any mistakes on this project, as it has immense implications for the future of the VA and the proper care of our millions of veterans. While you work together to create and integrated EHR platform, we request that you address the following questions in your response to us:

• Understanding the enormous scope of this project, what is the implementation and phasing plan?  What is the projected timeline and what are major completion milestones?
• Given the Federal government’s history of IT upgrade challenges, what are DOD’s best practices and lessons learned that can be adopted by the VA? What specific plans, controls or managerial tools are the VHA prepared to execute to ensure the aforementioned best practices are reviewed and adopted, when prudent?
• How can both Departments ensure the implemented solution will transcend DOD, VHA and community systems, following a veteran across the entirety of the provided care options, ensuring seamless, real-time access to medical records documentation?
• What, if any, legislative hurdles or policy barriers do you foresee, and how can we work together to ensure the success of this joint initiative? 
• What assessments of business process re-engineering will the VA undertake early in acquisition lifecycle of your EHR initiative?
• What oversight mechanisms will you put in place to ensure that the VA has a sufficient understanding of the existing business processes to be changed and that the VA will avoid excessive customization of the selected commercial off-the-shelf system?
• What efforts, if any, will be made to integrate Investment Review Boards (IRBs) at the beginning of the budget process to ensure sound budget decision-making in connection with this initiative?
• Do the DOD and VA intend to align the tenure of program executives responsible for the execution of this initiative with key decision points, to improve their ability to hold responsible personnel accountable?

Capitalizing on joint ventures between DOD and VA reduces redundancies, realizes economies of scale, and combines shared resources for more comprehensive solutions. We encourage both of you to explore additional areas within your departments for opportunities to collaborate. The unification of EHRs serves as the linchpin for further joint solutions. The American people deserve excellence from each of your departments, and we know each of you have the expertise and institutional knowledge to succeed through collaboration. Patriotic Americans volunteer to defend our nation and defend democracy around the world. Although the DOD and VA are different agencies, it is your joint obligation to support our patriots and their families in their journey, from first oath to eventual resting place. We owe our best to our brave warriors.

Sincerely,

Johnny Isakson   

John McCain                                                               

Jerry Moran

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 The Senate Committee on Veterans’ Affairs is chaired by U.S. Senator Johnny Isakson, R-Ga., in the 115th Congress. Isakson is a veteran himself – having served in the Georgia Air National Guard from 1966-1972 – and has been a member of the Senate Committee on Veterans’ Affairs since he joined the Senate in 2005. Isakson’s home state of Georgia is home to more than a dozen military installations representing each branch of the military as well as more than 750,000 veterans.