Rep. Frank Mrvan (D-IN) at a House VA Subcommittee on Technology Modernization
WASHINGTON — After underreporting the cost of its Electronic Health Record Modernization (EHRM) project by billions, VA is undertaking an independent cost analysis that is estimated to take as long as 12 months to complete. The move comes as Congress is seeking more transparency from the project and greater say on VA’s initiation of any significant IT projects going forward.
The independent analysis, which is being conducted by the Institute for Defense Analyses, was sparked by a VA Office of the Inspector General (OIG) report released in June that found VA neglected to include critical physical infrastructure upgrade costs in the estimates it provided to Congress. These include facility upgrades such as electrical, cabling, heating, cooling and ventilation required to support newly installed technology. Early VA estimates of these infrastructure costs have varied wildly and could add anywhere from $1.1 billion to $3.1 billion onto the already $16 billion project.
According to VA, the independent analysis will firmly define EHRM program activities and the life cycle costs associated with them.
Prior to VA’s announcement of the analysis last month, Congress had already begun work on a legislative mandate for the department to provide regular, accurate cost reporting of the EHRM project. In July, Democrat and Republican leaders of the House Veterans Affairs Committee introduced the VA Electronic Health Record Transparency Act.
“The bill will require VA to look at all costs across VA, OIT and any other program for any amount expended on EHRM, including for infrastructure projects,” explained Rep. Frank Mrvan (D-IN) at a House VA Subcommittee on Technology Modernization hearing last month. “It is clear to me that these infrastructure costs are a product of years of neglected infrastructure, and therefore not unique to EHRM. … I am interested in finding out the true cost of this large modernization program, and I know this bill will help us get that information.”
The legislation would require VA to provide Congress with a report on the ongoing costs of the project every 90 days until the program has been fully implemented, which is not expected to happen until 2028 at the earliest.
“We’re already monitoring the program’s obligations, but once VA places funding on the CERNER contract and other contracts, it goes into a black box,” said Rep. Matt Rosendale (R-MT). I’m particularly concerned about the spending because apparently they can resume implementing the CERNER EHR without demonstrating any quality or safety improvements.”
More Oversight
Legislators also are seeking to gain greater oversight on VA IT projects before they begin.
Immediately following the OIG reports in June, Rosendale submitted the VA Information Technology Reform Act. The bill would require VA to provide Congress with detailed cost estimates for any large IT projects prior to implementation.
The bill defines “large” as any project estimated to cost $50 million in a single year, $200 million for acquisition and implementation for the project’s duration or $500 million for total life cycle costs of the project.
“[This bill] would put an end to VA starting multimillion and multibillion dollar IT projects without publicly articulating their budgets, schedules and objectives,” Rosendale said at the subcommittee hearing last month. “It is inexcusable that not one of the IT projects that we oversee in this subcommittee—not a single one of them—was authorized by this Congress. The four largest projects total more than $27 billion. As for the smaller projects the budget does not contain a complete list and VA has never provided one. That means we cannot even say how many projects exist. Even worse, when all these projects started, VA failed to provide even the basic information needed to authorize them. We owe it to our veterans to do better.”
Paul Brubaker, acting principal deputy assistant secretary of VA’s Office of Information Technology, testified that VA supported the Transparency Act if it was amended to provide VA with time on the front end to gather better cost estimate data.
“The 90-day reporting timeline might not give us enough time to complete the EHRM independent cost analysis that we’re kicking off [in October],” he explained.
VA does not support the VA IT Reform Act, however, at least not the current version. According to Brubaker’s written testimony, the bill’s definition of what constitutes a “major information technology project” is vague and “does not reflect the reality of IT investments as defined by OMB.” Brubaker also noted that the cost thresholds in the bill are too low given modern-day IT expenditures.
Brubaker said that VA is willing to work with Congress on the technical language of the bill going forward.
