After 40 minutes of debate, the U.S. House of Representatives passed the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act on Monday night – but an original section that had dealt with matters related to the VA's ongoing electronic health record modernization was absent from the bill's text.

WHY IT MATTERS

The House Committee on Veterans’ Affairs announced that the "flagship veterans’ package," which focused on growing veteran job opportunities, improving the Veterans Affairs' community care program, removing roadblocks from disability benefits and improving care opportunities, had overwhelming bipartisan support.

"For nearly two years we have been listening to the veteran community to find the gaps within VA’s services to build a VA that meets the needs of today’s community and puts veterans – not government bureaucracy – at the center of the system," said the committee's chairman, Rep. Mike Bost, R-Ill., in a statement.

However, in the bill introduced on May 14, Title V – proposed as the Electronic Health Record Program Restructure, Enhance, Strengthen and Empower Technology Act of 2024 or the EHR Program RESET Act – included protections of veterans' personal information and set several implementation and reporting requirements which would have increased oversight of the beleaguered Oracle Cerner EHR by "appropriate congressional committees."

"The Secretary submits to the appropriate congressional committees a certification, including supporting data, that the metrics described in section … show overall improvement in each measurement period during the period beginning on the date of the enactment of this act and ending on the date on which the certification under this paragraph is made," according to deleted text from the original bill.

Of note, a provision was removed that could have resulted in a dramatic shift in delivering the VA's new EHR:

"Beginning on the date that is two years after the date of the enactment of this Act, the Secretary of Veterans Affairs may not exercise any option periods or optional tasks or extend any contracts to carry out the [EHRM], unless before the date that is two years after the date of enactment of this act."

The bill moved to the Senate on Tuesday.

THE LARGER TREND

Bost and other representatives have advocated to curtail the VA's modernization program. Introducing the EHRM Improvement Act last year, the House VA Committee chairman sought to require the VA and Oracle to demonstrate safety and efficacy before installing the new EHR at additional medical centers. 

"Far too many VA employees and veterans have been negatively impacted by the Oracle Cerner EHR system for the current project plan to continue at other VA sites before major improvements are made," said Bost in a fact sheet about the now-stalled legislation. 

Senators have also called for new oversight provisions in Oracle's contract review asking the VA to take the opportunity of the contract structure revised last year to hold the vendor responsible for software coding errors and other issues that compromise the quality and safety of its EHR deployments.

"We encourage you to use the opportunity the new contract structure provides to re-review terms and add additional accountability and oversight provisions to protect veterans and taxpayers," Sens. Jon Tester, D-Mont.; Patty Murray, D-Wash.; and Sherrod Brown, D-Ohio, said in their May 6 letter to VA Deputy Secretary Tanya Bradsher.

In a recent audit, the VA's Office of Inspector General found that action is still needed to mitigate risks to veterans in the VA's care caused by a lack of consistent response and weaknesses in several controls regulating EHR configuration management and monitoring.

This past week, President-elect Donald J. Trump nominated former Rep. Doug Collins, a Republican from Georgia, to take the helm as VA Secretary.

ON THE RECORD 

"This is a major milestone for our nation’s veterans, caregivers, survivors, and their families. The strong bipartisan passage in the House of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act is a fitting tribute to Senator Dole’s legacy of advocacy and service," said Steve Schwab, CEO of the Elizabeth Dole Foundation, in the House Committee on Veterans’ Affairs statement.

"We are profoundly grateful to the leadership in the House of Representatives and look forward to the swift passage of this legislation in the Senate," he said. "We must get this signed into law to bring meaningful change to those who have given so much for our nation."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.