While President Donald Trump’s proposed budget slashes funding to a host of agencies, the Department of Veterans Affairs would see and increase, and that has VA Secretary David Shulkin feeling good.
“We’ve charted a course for modernization: We need help to improve growth and make healthcare a reality for all veterans,” Shulkin told the House Committee on Veterans Affairs on Wednesday in his opening statement.
The proposed budget included $186.5 billion for the VA — a $6.4 billion increase from last year, and the funding will support the agency’s efforts to modernize and overhaul a system that has been wrought with controversy.
“Despite the differences we see going on in this administration, it’s nice to see we can come together to ensure care for our veterans and provide the resources necessary to support our veterans,” said Shulkin.
Part of this effort is a decision on whether to transition the VA’s outdated VistA IT system and EHR with either a commercial off-the-shelf product or hand over the programming to an outside vendor. Shulkin reiterated to the committee this decision will be made by July 1.
In fact, Shulkin is so committed to not continually “ask for money to fix a broken system,” the IT portion of the budget is significantly smaller than the committee expected. He explained that he’ll return to the committee to discuss the necessary procurement after the final fate of VistA is decided.
And if Shulkin decides to replace VistA with an off-the-shelf EHR, he’ll require additional funding and help from the committee.
The committee also focused on the continued funding of the Veterans Choice Program. Initially started as a stop gap as the VA responded to the 2015 scheduling and wait time scandals, the President has decided to continue the program through the coming year.
The program will help the VA “rethink how we do things,” said Shulkin. “We’ve been working on a program redesign that we believe will work better for veterans.”
The goal is to transform VA healthcare from an administrative system with offices out of reach of patients to more of a “clinical system that meets the clinical needs of the veterans we served.”
“We need to realign infrastructure modernize the system to increase interoperability,” said Shulkin. “When we talk about a highly integrated, high-performance system, we believe that’s what our veterans want. They want a strong VA system, so it’s important we’re providing strong services to our veterans.”
“As of now, about a third of all care in the VA is being delivered in the private system,” Shulkin said. And the Choice Program creates an opportunity to shift to a new model that builds private-public partnerships.
Shulkin also told Congress the VA will announce the expansion of its Epic medical system in the upcoming weeks. The VA contracted The Medical Appointment Scheduling System in 2015 to Epic and a Lockheed Martin subsidiary. The VA shelved the project, while the agency worked on an in-house system. Shulkin said the idea was to reduce the original $57 million contract for three of the pilots down to $6 million for a single pilot site.
“What we’re trying to do is make sure we’re not throwing money out,” he explained. “We want to demonstrate that it works for veterans. And once it’s successful we can surge the rollout.”