The Department of Veterans Affairs has claimed incremental progress in the massive project to make health records compatible with those of the Pentagon and participating private doctors, but the ultimate cost remains in question, according to the Government Accountability Office.
In a report last week, the GAO said that the VA "lacked insight into the total costs for the current system" of electronic health records, making it difficult to predict how much more it will cost to go to a new system.
It recommended that the VA "more reliably identify and report system costs," and the VA concurred.
According to the report, the VA spent $2.3 billion from fiscal 2015 to fiscal 2017 on its 36-year-old current VistA records system, formally known as the Veterans Health Information Systems and Technology Architecture.
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However, the GAO concluded that the VA could reliably account for only about $1 billion of the $2.3 billion spent.
In addition, Carol Harris, director of information technology acquisition management at the GAO, testified at a House Veterans Affairs Subcommittee on Technology Modernization last week that the $2.3 billion figure is probably off the mark.
She said that the VA's total spending on VistA from 2015 to 2017 "is likely to be more than the $2.3 billion."
The VA relies on VistA to provide health care services to more than nine million veterans annually.
For years, the VA has sought and failed to mesh its health records with those of the Defense Department, and the effort has been renewed under a 10-year, $10 billion contract signed in May 2018 with Cerner Corp. of Kansas City.
The VA has since estimated that the cost of the cloud-based contract could run as much as $16 billion over 10 years.
Last week, the VA announced that it had reached a major milestone in the transition -- the health records of 23.5 million veterans had been successfully transferred to a Cerner Corp. data center called Cerner Millennium EHR (Electronic Health Records).
The transfer moves the VA "one step closer" to creating an interoperable EHR system "that will improve military career transitions and drive better clinical outcomes," the department said in a news release.
"For decades, VA and DoD have been struggling to achieve interoperability and seamlessly share patient records between our health systems, placing an unfair burden on our veterans and their families," VA Secretary Robert Wilkie said in a statement.
"No veteran, family member or caregiver should have to carry boxes of paper, medical and service records around. This data migration is the first step to solving that problem for good," he said.
A major hurdle for the new system will be how well it adapts to interoperability with community care providers under the VA Mission Act, which went into effect in early June and expanded private-care options for veterans.
Under the previous VA Choice system, doctors often complained of late or incorrect payments, and veterans complained of co-pays.
At a Senate Appropriations Committee hearing in February, Sen. Steve Daines, R-Montana, said, "We've already spent $1.1 billion over five years on two previous efforts" to mesh VA records with those of the DoD.
"I'm just skeptical of this 10-year plan," he said. "By the time something gets implemented, it could be obsolete before it goes live."
-- Richard Sisk can be reached at Richard.Sisk@Military.com.