Representatives from both political parties stopped just short of scolding Department of Veterans Affairs leaders on their progress on fixing the VA's appointment scheduling system in a Sept. 26 hearing.
Members of the House Veterans Affairs subcommittee on technology modernization repeatedly raised "concerns" over the department's latest plan to develop software to replace the outdated system, VistA, which was not designed for mobile or web scheduling and could not handle the volume of the Veteran Health Administration's appointment-making demands.
A plan to extend the system's completion date by two years received criticism from multiple lawmakers.
"I need to see a lot more before I can put my confidence in this plan," said ranking member Rep. Jim Banks, R-Indiana. "First and foremost, I was disappointed to see the three-year scheduling implementation stretched out to five years before it even begins, and I'm not so sure that this still qualifies as, quote, 'accelerated.'"
The VA's ability to schedule medical appointments has come under intense scrutiny over the last five years, when news broke that veterans were dying while they waited for care and the VA had created a secret waiting list to hide how long veterans were waiting for care.
So after years of development, the VA successfully rolled out a new pilot appointment-booking system ahead of schedule in April 2018. However, the department decided to halt the program's expansion as a different company, Cerner, is developing a new electronic health records system and VA leaders did not want to have to integrate that scheduling system with the Cerner health records program in the future.
"When you consider the fact that we have 130 disparate solutions within the framework of VA today, incorporating another integration [is a] challenge," said John Windom, executive director of the VA Office of Electronic Health Record Modernization. "One of the toughest parts of our job is that we have to integrate into an existing solution and minimize the disruption that takes place to our care provisions."
But committee chairwoman Rep. Susie Lee, D-Nevada, worried that scrapping a successful scheduling solution is wasteful and there's a possibility of "change fatigue."
"Wait times continue to be [a] complicated and an unfortunate situation at the VA that must be addressed," Lee said. "I have several serious reservations with this mid-flight change of approach."
Lawmakers are also concerned about past issues raised by the Office of the Inspector General around high staffing turnover, improper project management and spending. In particular, Lee said she worries about creating a monopoly by having only one company develop multiple programs.
"I'd like to see as we move forward in this, what moves we are making to make sure that other vendors and other providers have access to this type of technology without having to make a contract with one provider moving forward," she told the six-person panel of staff from the VA and the Office of Inspector General.
"All of you have the potential to really revolutionize electronic health records," Lee said, "not just for the DoD and VA, but for all of health care providers across this country."