[Congressional Record Volume 164, Number 83 (Monday, May 21, 2018)]
[House]
[Pages H4253-H4254]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 VETERANS' ELECTRONIC HEALTH RECORD MODERNIZATION OVERSIGHT ACT OF 2017

  Mr. DUNN. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 4245) to direct the Secretary of Veterans Affairs to submit to 
Congress certain documents relating to the Electronic Health Record 
Modernization Program of the Department of Veterans Affairs.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4245

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans' Electronic Health 
     Record Modernization Oversight Act of 2017''.

     SEC. 2. OVERSIGHT OF ELECTRONIC HEALTH RECORD MODERNIZATION 
                   PROGRAM.

       (a) Program Documents.--Not later than 30 days after the 
     date of the enactment of this Act, the Secretary of Veterans 
     Affairs shall submit to the appropriate congressional 
     committees the following documents concerning the Electronic 
     Health Record Modernization Program:
       (1) Integrated Master Plan.
       (2) Integrated Master Schedule.
       (3) Program Management Plan.
       (4) Annual and lifecycle cost estimates, including, at a 
     minimum, cost elements relating to--
       (A) Federal Government labor;
       (B) contractor labor;
       (C) hardware;
       (D) software; and
       (E) testing and evaluation.
       (5) Cost baseline.
       (6) Risk Management Plan.
       (7) Health IT Strategic Architecture Plan.
       (8) Transition Plan for implementing updated architecture.
       (9) Data Migration Plan.
       (10) System and Data Security Plan.
       (11) Application Implementation Plan.
       (12) System Design Documents.
       (13) Legacy Veterans Information Systems and Technology 
     Architecture Standardization, Security Enhancement, and 
     Consolidation Project Plan.
       (14) Health Data Interoperability Management Plan.
       (15) Community Care Vision and Implementation Plan, 
     including milestones and a detailed description of how 
     complete interoperability with non-Department health care 
     providers will be achieved.
       (b) Quarterly Updates.--Not later than 30 days after the 
     end of each fiscal quarter during the period beginning with 
     the fiscal quarter in which this Act is enacted and ending on 
     the date on which the Electronic Health Record Modernization 
     Program is completed, the Secretary shall submit to the 
     appropriate congressional committees the most recent updated 
     versions, if any exist, of the following documents:
       (1) Integrated Master Schedule.
       (2) Program Management Plan, including any written Program 
     Management Review material developed for the Program 
     Management Plan during the fiscal quarter covered by the 
     submission.
       (3) Each document described in subsection (a)(4).
       (4) Performance Baseline Report for the fiscal quarter 
     covered by the submission or for the fiscal quarter ending 
     the fiscal year prior to the submission.
       (5) Budget Reconciliation Report.
       (6) Risk Management Plan and Risk Register.
       (c) Contracts.--Not later than five days after awarding a 
     contract, order, or agreement, including any modifications 
     thereto, under the Electronic Health Record Modernization 
     Program, the Secretary shall submit to the appropriate 
     congressional committees a copy of the entire such contract, 
     order, agreement, or modification.
       (d) Notification.--
       (1) Requirement.--Not later than 10 days after an event 
     described in paragraph (2) occurs, the Secretary shall notify 
     the appropriate congressional committees of such occurrence, 
     including a description of the event and an explanation for 
     why such event occurred.
       (2) Event described.--An event described in this paragraph 
     is any of the following events regarding the Electronic 
     Health Record Modernization Program:
       (A) The delay of any milestone or deliverable by 30 or more 
     days.
       (B) A request for equitable adjustment, equitable 
     adjustment, or change order exceeding $1,000,000 (as such 
     terms are defined in the Federal Acquisition Regulation).
       (C) The submission of any protest, claim, or dispute, and 
     the resolution of any protest, claim, or dispute (as such 
     terms are defined in the Federal Acquisition Regulation).
       (D) A loss of clinical or other data.
       (E) A breach of patient privacy, including any--
       (i) disclosure of protected health information that is not 
     permitted under regulations promulgated under section 264(c) 
     of the Health Insurance Portability and Accountability Act of 
     1996 (Public Law 104-191; 42 U.S.C. 1320d-2 note); and
       (ii) breach of sensitive personal information (as defined 
     in section 5727 of title 38, United States Code).
       (e) Definitions.--In this section:
       (1) The term ``appropriate congressional committees'' 
     means--
       (A) the Committees on Veterans' Affairs of the House of 
     Representatives and the Senate; and
       (B) the Committees on Appropriations of the House of 
     Representatives and the Senate.
       (2) The term ``Electronic Health Record Modernization 
     Program'' means--
       (A) any activities by the Department of Veterans Affairs to 
     procure or implement an electronic health or medical record 
     system to replace any or all of the Veterans Information 
     Systems and Technology Architecture, the Computerized Patient 
     Record System, the Joint Legacy Viewer, or the Enterprise 
     Health Management Platform; and
       (B) any contracts or agreements entered into by the 
     Secretary of Veterans Affairs to carry out, support, or 
     analyze the activities under subparagraph (A).

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Dunn) and the gentleman from Minnesota (Mr. Walz) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida.


                             General Leave

  Mr. DUNN. Mr. Speaker, I ask unanimous consent that all Members have 
5 legislative days in which to revise and extend their remarks and 
insert extraneous material in the Record on H.R. 4245.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. DUNN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4245, the Veterans' 
Electronic Health Record Modernization Oversight Act of 2017.
  This is not just a transition to a commercial EHR. If successful, it 
will be a transformation of how the VA delivers and manages healthcare 
to 9 million veterans. But the path to achieving a seamless, 
interoperable health record is far from clear.
  Much has already been said about the program's price tag: nearly $16 
billion over 10 years. It is a gigantic management exercise, involving 
thousands of people. It is also an immense challenge to document 
clinical processes, maybe for the first time, that doctors and nurses 
have been performing for years, and reengineer them.
  H.R. 4245 would ensure that the committee gets access to this 
program's key performance reports and contractual documents. It would 
also require the VA to notify us when significant negative events 
occur.
  The time to enact legislation is now. The VA awarded its primary 
contract to the Cerner Corporation at the end of last week.
  Mr. Speaker, I thank Ranking Member Walz for spearheading this 
effort. I also appreciate Jack Bergman and Ann Kuster, the chairman and 
ranking member of the Oversight and Investigations Subcommittee, for 
their work on H.R. 4245, and the oversight spade work that they do 
every day.
  Mr. Speaker, I urge my colleagues to support H.R. 4245, and I reserve 
the balance of my time.
  Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
  I rise in support of H.R. 4245, the Veterans' Electronic Health 
Record Modernization Oversight Act of 2017.
  When I first came to Congress back in 2007, as a veteran myself, one 
of the questions we asked was--Electronic medical records had been out 
there for quite some time. The VA was a pioneer in their VistA System, 
on VistA, on

[[Page H4254]]

managing health, and it is not just a database. As Dr. Dunn knows well, 
these are important diagnostic tools and they have to be right.
  But the thing that every veteran for 20 years was saying was: Why do 
we have one medical record in the Department of Defense, so when we 
leave the Army, the Navy, the Marines, or the Air Force, we drop off a 
cliff--we all carry around a paper file they print out to us--and then 
we try to get back into the VA and it is an entirely different system 
that doesn't talk to one another?
  It seems pretty self-evident that from the time you raise your hand 
until the time you are buried with honors, it would make sense that we 
had a joint electronic medical record. That was the genesis of this.
  I am proud to say that it was a long road, but we had the signing of 
the Cerner contract.
  What this piece of legislation does is--and I want to be very careful 
about--we do this many times here, we pass a piece of legislation, pat 
ourselves on the back, and send it away, only to watch it die a 
horrible death in the executive branch, not be implemented correctly, 
or not provide our oversight.
  This simply says--and Dr. Dunn was exactly right--this is a $16 
billion 10-year project. I want to be clear, though: that is our 
current projection.
  Everyone in here knows that if we get a 10 percent delay and a 10 
percent cost overrun, we will probably be relatively happy with that. 
That is over a year, and it will be a nearly $2 billion addition. That 
money will have to come from somewhere. It will slow down 
implementation. We saw reports early last week that there were serious 
concerns in the pilot program that are out there.
  So what this does--and I, once again, thank the chairman and the 
majority staff for recognizing this is our responsibility. We will not 
shirk that here--it asks them to report to us. It let's us stay on top 
of this before it becomes a crisis. Because every single one of us here 
knows that it is coming some day--that we are going to hear about 
misinformation, something dropping through, a cost overrun--and this 
just gives us that added security.
  This is a project that cannot fail. I have witnessed in my time in 
Congress too many IT failures, specifically at the VA: a contract is 
signed, it is going to happen, and it is a good thing. It has the 
potential to, as again the gentleman said, revolutionize how we deliver 
care. But it has the potential to go in the wrong direction if we are 
not doing our constitutional right of oversight.
  Mr. Speaker, I urge my colleagues to support this piece of 
legislation.
  Mr. Speaker, I think this is, once again, the legislative branch, as 
it was meant to be, taking back its oversight responsibility. We are 
going to authorize this and we are going to appropriate the funds. I 
think it is only prudent that we have another layer of oversight to 
make sure that this huge, huge project, nearly unprecedented, upgrade 
in integration of electronic health records of anywhere in the world, 
happens correctly.
  Mr. Speaker, I encourage a ``yes'' vote on this, and I yield back the 
balance of my time.
  Mr. DUNN. Mr. Speaker, once again, I encourage all Members to support 
H.R. 4245, and I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4245, 
the Veterans' Electronic Health Record Modernization Oversight Act of 
2017.
  Mr. Speaker, one way the nation can express its deepest appreciation 
for our service men and women is to ensure that their health records 
are handled appropriately.
  H.R. 4245 directs the Secretary of Veterans Affairs to submit certain 
documents to Congress relating to the Electronic Health
  Record Modernization Program of the Department of Veterans Affairs.
  More than 20 million brave Americans are veterans of our nation's 
armed services including more than 1.5 million women, 2.4 million 
African American men and women, 1.4 million Hispanic men and women, 
320,000 Asian Americans, and 145,000 American Indians.
  Of these veterans, more than 1.4 million reside in my home state of 
Texas.
  Harris County, the county which contains my home district, has over 
187,000 veterans which is the largest veteran population of any county 
in Texas.
  More than 9 million veterans and their families are enrolled in the 
VA health care system, making it the largest health care system in the 
nation.
  This system employs more than 306,000 full time health care 
professionals and support staff at 1,240 health care facilities, 
including 170 VA Medical Centers and 1,061 outpatient sites.
  Mr. Speaker, our veterans bravely put their lives on the line to 
defend our freedoms and to keep our nation safe.
  By passing H.R. 4245, the modernization of veterans' health records 
will receive the attention it deserves in order to enhance their 
rehabilitation and quality of life.
  The Veterans' Electronic Health Record Modernization Oversight Act of 
2017 requires the Secretary of Veterans Affairs to submit documentation 
to Congress regarding the agency's efforts to modernize its health 
record system.
  This will serve as a vital resource to enable us to assist our 
veterans as they overcome burdensome health problems.
  I urge my colleagues to join me in supporting H.R. 4245 to show their 
support and gratitude for the sacrifices made by our service men and 
women, and to ensure that veterans receive the care and rehabilitation 
they deserve.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Dunn) that the House suspend the rules and 
pass the bill, H.R. 4245.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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