The Veterans Affairs Department's long-planned switch for its EHR system may not have budgeted enough money for necessary infrastructure upgrades, and the whole update may cost more than the department's initial budget of $16 billion, according to a new government report.
While VA has developed two cost estimates for physical infrastructure upgrades, including heating, cooling, ventilation and cabling, the Veterans Affairs Office of Inspector General said they don't meet government standards. The OIG also determined that the VA's Office of Electronic Health Record Modernization, which is responsible for implementing the new EHR platform, didn't provide adequate cost estimates to Congress. The watchdog said VA and the office will have to improve their planning and coordination over the next year.
The VA's cost estimates for the infrastucture upgrades were far lower than previously disclosed in more detailed reports, OIG said. Two reports in 2019 estimated the department were $1 billion to $2.6 billion short of the funds needed, which could put a strain on VA medical resources.
Lawmakers are growing impatient with the mismanagement of the EHR project, which was slated for completion in 2029. The new multibillion-dollar system allows providers to access medical records from the Defense Department to better care for the 9 million veterans served by the VA.
The OIG also found that VA didn't have an independent cost estimate for its facilities, and didn't communicate the requirement to the Office of Electronic Health Record Modernization.
Ultimately, life-cycle costs, which disclose funding required throughout the program to implement the new record system, didn't include any reliable estimates for upgrades to physical infrastructure.
"For the past three years our committee has repeatedly requested these (EHR) cost estimates but VA has failed to provide them," said Rep. Mark Takano (D-Calif.), who is chairman of the House Committee on Veterans Affairs.
The OIG recommended an independent cost estimate for life-cycle cost estimates be completed by the VA assistant secretary and CFO, as well as a full disclosure of physical infrastructure costs and agendas.
