At the Senate Committee on Appropriation meeting U.S. Department of Veterans leaders were once again in the spotlight to discuss interoperability, the modernization of the VistA electronic health record system and plans for the future.

But while there was much talking about its current plans, and roadblocks impeding a fully interoperable system with the U.S. Department of Defense, it's clear there's still an abundance of work to be done.

Sen. Jon Tester, D-Montana, led the charge to figure out a definitive timeline for these projects and what they would entail. In questioning VA leaders, including David Waltman, chief information strategy officer of the Veterans Health Administration, Tester made it clear he was frustrated with the lack of clarity in the conversation.

Having served for almost 10 years on the Senate Benefits Committee, some of the first discussions in 2007 talked about interoperability between the VA and DoD. And we're 10 years later, with incredible advances in technology, and yet, here we are, Tester expressed.

[Also: CIO LaVerne Council says VA needs new EHR with analytics, cloud, patient experience capabilities]

"When do you get to a point where you are satisfied with the transfer of information being complete?" Tester asked during the Tuesday hearing. 

While Waltman attempted to explain the progress in depth, Tester interrupted: "The question was, when are we going to be able to do this? And I'm going to tell you, I can filibuster you, better than you can filibuster me. But the question is pretty clear… tell me when you're going to be able to achieve this level. That's it."

Waltman stressed the system will be interoperable by Fiscal Year 2018, but not completely. The ability to incorporate the data between all of the departments will be possible, he said, as will some of the analytics and algorithms. "But I can't say that every use case we have identified for interoperable data will be possible."

To further the intent of the sub-committee, Sen. Mark Kirk, R-Illinois, noted how Cerner addresses a key VA priority, suicide prevention, through the use of an algorithm that "could predict likelihood suicide rates." Which he stressed was a major concern for the VA.

Kirk countered that "this critical upgrade in suicide prevention, we are not capable of doing this with the Joint Legacy Viewer." The JLV is a web-based platform that allows both the DoD and VA to view and worth with each other's records.

VA Chief Information Officer LaVerne Council stressed the need for building a platform that would act as a backbone to the current system. And although VistA is on schedule to be fully-interoperable by Fiscal Year 2018, it's clear the system is still flawed.

Council also said there's no system available on the market able to handle the amount of data required.

U.S. Government Accountability Office Director of IT Valerie Melvin asserted that they need a a transparent analysis of VistA alternatives and which ones are sufficient or not. 

"They have identified some of the standards that they need," said Melvin. "We have not seen other aspects of what they intend to do in terms of putting either the interoperable component together between the VA and DoD, or the planning that's necessary for VA's VistA modernization."

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com

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