[Congressional Record Volume 167, Number 199 (Tuesday, November 16, 2021)]
[House]
[Pages H6278-H6279]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          VA ELECTRONIC HEALTH RECORD TRANSPARENCY ACT OF 2021

  Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4591) to direct the Secretary of Veterans Affairs to submit 
to Congress periodic reports on the costs of the Department of Veterans 
Affairs Electronic Health Record Modernization program, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4591

       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 ``VA Electronic Health Record 
     Transparency Act of 2021''.

     SEC. 2. REPORTS ON COSTS, PERFORMANCE METRICS, AND OUTCOMES 
                   OF DEPARTMENT OF VETERANS AFFAIRS ELECTRONIC 
                   HEALTH RECORD MODERNIZATION PROGRAM.

       (a) In General.--Section 503 of the Veterans Benefits and 
     Transition Act of 2018 (Public Law 115-407; 38 U.S.C. 5701 
     note prec.) is amended--
       (1) by redesignating subsection (e) as subsection (f);
       (2) by inserting after subsection (d) the following new 
     subsection (e):
       ``(e) Quarterly Reports.--
       ``(1) Reports on costs of ehrm program.--Not later than 90 
     days after the date of the enactment of the VA Electronic 
     Health Record Transparency Act of 2021, and every 30 days 
     after the last day of each fiscal quarter thereafter until 
     the termination date specified in paragraph (3), the 
     Secretary of Veterans Affairs shall submit to the Committees 
     on Veterans' Affairs of the Senate and House of 
     Representatives a report on the costs of the Electronic 
     Health Record Modernization program of the Department of 
     Veterans Affairs. Each such report shall include, for the 
     period covered by the report and for the total period 
     beginning on the date of the enactment of the VA Electronic 
     Health Record Transparency Act of 2021 and ending on the date 
     of the submittal of the report, a description of all actual 
     expenses of, and driven by, such program, including any such 
     expenses paid using--
       ``(A) any funds appropriated for the Department of Veterans 
     Affairs, for any source or account, expended by any 
     organizational element of the Department or by the Federal 
     Electronic Health Record Modernization Office for the 
     Electronic Health Record Modernization Program;
       ``(B) any funds, from any source or account, expended by 
     any organizational element of the Department for physical or 
     technology infrastructure modifications, enhancements, 
     improvements, or expansions at a facility of the Department 
     necessitated by, or related or pertaining to, the Electronic 
     Health Record Modernization Program; and
       ``(C) any funds, from any source or account, expended by 
     any organizational element of the Department or by the 
     Federal Electronic Health Record Modernization Office for 
     consultants, support contractors, or experts related or 
     pertaining to the Electronic Health Record Modernization 
     Program.
       ``(2) Reports on performance metrics and outcomes.--Not 
     later than 90 days after the date of the enactment of the VA 
     Electronic Health Record Transparency Act of 2021, and every 
     30 days after the last day of each fiscal quarter thereafter 
     until the termination date specified in paragraph (3), the 
     Secretary of Veterans Affairs shall submit to the Committees 
     on Veterans' Affairs of the Senate and House of 
     Representatives a report on the performance metrics and 
     outcomes of the Electronic Health Record Modernization 
     Program. Each such report shall include, for the period 
     covered by the report--
       ``(A) a list of the quality, performance, safety, or value 
     metrics, key performance indicators, and other diagnostic or 
     evaluation criteria in use to assess the Electronic Health 
     Record Modernization Program and the electronic health record 
     system, in general and at individual facilities, with respect 
     to veterans, employees of the Department, and Departmental 
     operations;
       ``(B) an explanation of any change to any of such metrics, 
     indicators, and criteria compared to the metrics, indicators, 
     and criteria included in any previous report submitted under 
     this paragraph;
       ``(C) the data supporting or demonstrating each such 
     metric, indicator, and criteria compared to the data 
     supporting or demonstrating such metric, indicator, or 
     criteria as included in the previous report submitted under 
     this paragraph; and
       ``(D) a list of patient safety reports, incidents, alerts, 
     or disclosures at each facility of the Department where the 
     electronic health record system has been implemented.
       ``(3) Termination date.--The requirement to submit a report 
     under paragraph (1) shall terminate on the date that is 90 
     days after the date on which the Secretary submits to the 
     Committees on Veterans' Affairs of the Senate and House of 
     Representatives certification that the Electronic Health 
     Record Modernization program has been fully implemented.''; 
     and
       (3) in subsection (f), as redesignated by paragraph (1), by 
     adding at the end the following new paragraphs:
       ``(3) The term `electronic health record system' means the 
     electronic health record system implemented pursuant to the 
     Electronic Health Record Modernization Program.
       ``(4) The term `Federal Electronic Health Record Management 
     Office' means the office established under section 1635(b) of 
     the Wounded Warrior Act (title XVI of Public Law 110-181; 10 
     U.S.C. 1071 note).
       ``(5) The term `facility of the Department' includes a 
     joint facility of the Department of Veterans Affairs and the 
     Department of Defense.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Illinois (Mr. Bost) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
to insert extraneous material on H.R. 4591, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4591, the VA Electronic 
Health Record Transparency Act of 2021, as amended.
  The Department of Veterans Affairs has struggled to produce reliable 
cost estimates and reporting on the infrastructure needs associated 
with its $16 billion electronic health record modernization project. 
This bill is a good governance measure which will enable Congress to 
conduct better oversight and hold VA accountable for its spending.
  It is essential that we ensure that taxpayer funds meant to serve 
veterans are being used properly and that VA is maintaining detailed 
records of its IT and physical infrastructure expenditures. We owe that 
to the veterans who get their care from VA and to the American 
taxpayer.
  Mr. Speaker, I urge all of my colleagues to support H.R. 4591, as 
amended, which was unanimously supported in committee.
  I reserve the balance of my time, Mr. Speaker.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4591, as amended, the VA 
Electronic Health Record Transparency Act.
  Since the very beginning of the Electronic Health Record 
Modernization, or the EHRM, program, this committee has been requesting 
accurate and up-to-date lifecycle cost estimates from VA. Despite our 
requests, VA has never provided a credible lifecycle cost estimate. 
VA's cost estimates could not withstand even the most basic scrutiny.

[[Page H6279]]

  This bill would require quarterly reports on the costs of the EHRM 
program. It would also capture the roughly $5 billion of costs the 
Inspector General found were unaccounted for and any other costs that 
VA has not been including.
  Of course, cost is not everything. The electronic health record 
program needs to help the VA medical staff better care for veterans. 
That is why this bill would also require VA to report on performance 
and safety metrics. These data points will allow us to evaluate the 
program and determine whether it is making VA medical centers safer, 
faster, and better.
  Mr. Speaker, I am proud of the bipartisan work of the Technology 
Modernization Subcommittee, and I am also pleased to be the original 
cosponsor of this bill.
  Mr. Speaker, I encourage all of my colleagues to support H.R. 4591, 
as amended, and I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield 3 minutes to the gentleman from 
Indiana (Mr. Mrvan), who is my good friend and a member of the House 
Committee on Veterans' Affairs and chairman of the Subcommittee on 
Technology Modernization.
  Mr. MRVAN. Mr. Speaker, I thank Chairman Takano for yielding me time.
  Mr. Speaker, earlier this year the VA Office of the Inspector General 
released two separate reports highlighting VA's failure to conduct 
reliable lifecycle cost estimates for its Electronic Health Record 
Modernization program.
  Specifically, the IG repeatedly found unreliable and incomplete 
estimates for infrastructure upgrades and costs as well as inadequate 
reporting of those costs.
  Given the size and scope of the EHRM program, the lack of accurate 
cost estimates hampers VA's ability to provide Congress with an 
accurate picture of the cost and scale of efforts to modernize IT and 
physical infrastructure at VA medical centers.
  This piece of legislation will address these issues. It requires VA 
to look at all costs across VHA, OIT, and any other programs for any 
amount expended on the EHRM program, including for infrastructure 
projects and contractors that were not part of the original contract. 
This legislation also requires VA to provide the committee with reports 
on performance metrics and outcomes.
  I thank Chairman Takano and Ranking Member Bost for their leadership 
and for cosponsoring this legislation as well as all of the other 
cosponsors and the committee members who have truly made this a 
bipartisan effort.
  Mr. Speaker, I encourage my colleagues to support this bill.

                              {time}  1230

  Mr. BOST. Mr. Speaker, I encourage all of my colleagues to support 
this bill, and I yield back the balance of my time.
  Mr. TAKANO. Mr. Speaker, I ask all of my colleagues to join me in 
passing H.R. 4591, the VA Electronic Health Record Transparency Act of 
2021, as amended, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 4591, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to direct 
the Secretary of Veterans Affairs to submit to Congress periodic 
reports on the costs, performance metrics, and outcomes of the 
Department of Veterans Affairs Electronic Health Record Modernization 
program.''.
  A motion to reconsider was laid on the table.

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