Banks Expresses Concern Over VA’s Loss of Focus on Health IT Innovation

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Fort Wayne, October 11, 2018 | comments

Congressman Jim Banks (IN-03), Chairman of the House Veterans’ Affairs Subcommittee on Technology Modernization, yesterday sent a letter to the Department of Veterans Affairs (VA) Acting Deputy Secretary James Byrne expressing concern over VA’s apparent loss of focus on two of its own initiatives, which have blockbuster potential to enhance the department’s interoperability with its community partners and allow it to tap into the private sector’s technological advancements.

Read the full letter here and below:

October 10, 2018

The Honorable James Byrne
Acting Deputy Secretary
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420

Dear Acting Deputy Secretary Byrne:

As the VA senior leader ultimately responsible for EHR Modernization, I write you to express my concern over VA’s apparent loss of focus on the open-Application Program Interface (API) gateway interoperability platform concept that VA has explored for over two years and the “open-API pledge” that the department encouraged hundreds of developers to sign in March of this year.

As you know, the open-API gateway idea has gone by various names, originally the Digital Health Platform, then the Digital Veterans Platform, and later Lighthouse. Unfortunately, it seems to have lost momentum. The Committee has previously advocated for the concept, though there were some differences of opinion in how VA envisioned it. Chairman Roe encouraged former Secretary Shulkin to implement a best-in-class EHR within the context of an interoperability platform and not merely build interoperability capabilities inside an EHR, and the idea became a major focus of the interoperability assessment that VA commissioned from the MITRE Corporation before signing the Cerner contract.

Even beyond medical records exchange, VA needs a flexible platform to translate data coming in from multiple EHRs and on which to build (and so its private sector partners can build) interfaces to and from medical practices’ billing systems, insurance companies, external applications, veterans’ devices, and one day Medicare and TRICARE’s systems. To meet the challenge, the interoperability platform should include alongside the open-API gateway a cloud broker capability to integrate multiple cloud environments.

I have no doubt that you are focused on the challenge of anticipating technological evolution over the EHR Modernization program’s expected 10-year implementation timeline. It may be impossible to anticipate what is to come, yet the need to “future-proof” the technology that VA is acquiring is very real. Moving forward with the open-API gateway and sustaining the “open-API pledge” are important steps to do that. Even with the unprecedented resources that Congress has given VA for health IT modernization, the department cannot possibly buy or develop every capability. Luckily, there are literally hundreds of startups and established companies that are eager to offer their solutions, many of which have already been created at private expense. What is needed is a culture to welcome them and a platform to support them.

Please advise whether the open-API gateway concept is still under consideration and what timeframe and parameters, if any, are in place to make a decision. Please also explain whether VA is still committed to the “open-API pledge” and what is being done to promote and advance it. If you have any questions or wish to discuss these matters, please do not hesitate to have your staff contact Mr. William Mallison, Majority Staff Director of the Subcommittee on Technology Modernization at (202) 225-1900 or william.mallison@mail.house.gov.

Sincerely,

Congressman Jim Banks

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Interested members of the media may contact Andrea Palermo at andrea.palermo@mail.house.gov.

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