Tom Barrett Questions Doug Collins About The VA's Electronic Health Record Modernization Efforts

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During a House Veterans' Affairs Committee hearing last week, Rep. Tom Barrett (R-MI) questioned VA Secretary Doug Collins about the department's electronic health record modernization efforts.

Transcript

00:00Representative Barrett, you're recognized for seven minutes.

00:03Thank you, Mr. Chairman and Secretary.

00:05Great to see you again.

00:06And I want to start by thanking you for coming to Michigan last month,

00:11spending time with veterans in my district.

00:13We deeply appreciated that and appreciate your commitment to fulfilling the mission we have

00:18to every single one of our veterans across the country

00:21and the interest you took to come to Michigan.

00:24We really appreciate and appreciate your willingness to step up in serving this role.

00:28I know that it's not always easy to step into the management role of such a large organization

00:34with a lot of political pressure and a lot of spotlight on you.

00:37So thank you for being willing to do that.

00:41I wanted to ask you specifically about the electronic health record modernization

00:45and the increased funding in the budget proposal before us.

00:51And I wanted to ask how this enhancement in funding is going to be used to ensure that we have a success

00:57in the electronic health record rollout, knowing that we've had challenges with the program in the past.

01:04Thank you, Congressman.

01:05I do appreciate the commitment, especially in your area,

01:08because, you know, April next year, the four sites will be going live in Michigan.

01:12I think it's just a restart is what we have to sort of look at here.

01:16This was a system that had been broken in the sense that nobody was working with it.

01:21They were not, they just sort of went to their corner and just held the ball and money was being wasted all the time.

01:29So what we did is restarted the system from minute one.

01:31One of the biggest issues that I'd heard that was a concern, not only from a perspective of patient safety,

01:38patient quality, dealing with these health records,

01:40is it did put my understanding, at least looking back on some of the stuff in Washington State and Oregon,

01:46is that it was not working properly and it was actually giving some bad results.

01:50That's just an issue there.

01:52Most of that came from the situation in which we didn't standardize what we were doing.

01:56They just sort of were allowed to do whatever they wanted to do.

01:59One of the ways going forward is we're holding accountable on a very short timeline on our end

02:04to make sure that all of our employees are trained, everybody's going to be up to speed,

02:08and we're speeding up that integration process.

02:11We're also holding Oracle accountable for realistic time limits and also bidding the equipment in

02:17and also adding things such as AI and others on top of that to help our doctors in their treatments

02:23and the nurses as well, practitioners going forward,

02:25which is something they see in the private sector right now if they just walked across the street

02:29and went into a private care facility.

02:30So we believe that we're putting in the safeguards to make sure that going forward this is going to be something

02:36that can actually work, but also giving it the tools to expand in a quicker fashion.

02:42I appreciate that.

02:43I chair the Technology Modernization Subcommittee here,

02:47and one of the issues we've taken up is the external provider scheduling program.

02:53One thing that was clear throughout that hearing we had recently is that provider participation

02:59is really critical in making sure that EPS works for veterans

03:03and reducing that community care appointment wait time and the seamless integration there.

03:07I personally had an experience with the community care scheduling that was fraught with challenges and problems.

03:14Can you tell us what steps the VA is taking to encourage community care providers

03:17to participate in EPS and educate them about the program

03:21and not delay the implementation or discourage its use?

03:25Yeah, and this is something I think that anybody sitting in my position right now

03:29would have this problem, and I don't care which administration it could be going forward

03:33because, frankly, the third-party administrating of this has been a problem and struggle,

03:38and I'm not saying completely their fault.

03:40I think there's a VA component to this as well on things that we've done

03:44to exacerbate the problem going forward.

03:47One of the things, and I don't think I've mentioned it.

03:49This is my second hearing, but if I've not mentioned it already,

03:51I want to at least emphasize this again, is that when about the second week that I was on the job,

03:56it was brought to my attention that we could not put out the contract RFI

04:01for the third-party administrators this year as we were supposed to

04:04because the work was supposed to have been, and police don't hear me just trying to say blame,

04:08but this is just an honest assessment.

04:10They didn't do it last year.

04:12Basically, it was supposed to have been done in the fall of last year

04:14in the previous administration.

04:15They just didn't do it.

04:16So the groundwork, legwork to work up to this was not done.

04:19So we had to put it off a year, but what it's given us the ability to do now

04:24is spend time looking at the qualifications for these contracts, looking at these things.

04:28I think one of the latest conversations I've had with some of our folks looking at this system

04:33is there's going to be literally hundreds of changes to the RFI proposal

04:38so that we get better work with our community care doctors and with our VA.

04:43Just to let you know on this committee, if you've not understood this issue,

04:46one of the problems is, and some of the doctors have alluded to this,

04:49is that you have doctors who cannot communicate with our system,

04:53and our system doesn't communicate to them.

04:54So they're waiting weeks with, I kid you not, we're faxing information.

04:59We're putting it on compact disc and sending it up.

05:02This is something all of us could hold hands and say, why are we doing this?

05:06But this is what's been going on, and that's what's delaying care for our veterans.

05:09Yeah, no, I appreciate that, and it felt like there was a bit of a dragging of feet

05:15to get this integrated and to expand it.

05:18One thing I raised in committee that I'm hopeful we can look at

05:22is if we're doing the change management around the electronic health record modernization

05:26and upgrade and rollout to these facilities,

05:29it might be the appropriate time to put them onto this scheduling program at the same time

05:33so that we're doing that kind of comprehensively or with some thought there.

05:37I'm not in your position to kind of discern that practicality or not,

05:42but I do think that we need to do a far better job of rolling this out

05:46in a much more aggressive fashion to kind of achieve the benefit

05:49of getting these things scheduled in a timely way for our veterans.

05:52I agree, and it's not just the issue of inside of our own facilities.

05:55It's also the veteran using it as well.

05:57And so it's a two-fold purpose of how we're training and how we're also rolling this out.

06:02I feel good about where we are now, and anything that we can add on,

06:05I've already experienced to Oracle that we expect compliance, we expect this to go forward.

06:13Fortunately, about three weeks ago, the Senate confirmed my deputy, Paul Lawrence,

06:17to be our deputy secretary.

06:20That is statutorily under his purview, and I've turned him loose to do that.

06:24He's getting involved now heavily on a weekly basis and even a daily basis on it.

06:28So anything we can add will be definitely looking forward.

06:31We look forward to working together through the subcommittee in that effort

06:35and appreciate you being here today.

06:36And with that, Mr. Chairman, I'll yield back.

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