Secretary of Veterans Affairs David Shulkin, MD, told a Senate subcommittee on Wednesday he does not yet know the cost for the new Cerner electronic health record that the VA plans to purchase.
While Sen. Brian Schatz, D-Hawaii, said he supports the decision to replace the VA’s existing Vista EHR, he worried the cost was not part of the 2018 budget. “I understand you don’t want to just pick a number,” Schatz told Shulkin. “But it’s not zero. And we’re about to mark this bill up and it’s difficult to do a markup when, lacking information, we’re expected to sort of book it at zero.”
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Shulkin agreed: “It’s not zero. We don’t know the cost yet.”
“It makes me extremely nervous that you say you can absorb these costs,” Schatz said. “The EMR thing is a brand new hard cost. You’re going to have to cannibalize your budget to some extent … are you not?”
Schatz was not the only lawmaker worried about whether it would be enough to handle unanticipated expenses.
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Sen. Jon Tester, D-Montana, said the EHR system could run as much as $16 billion and advised against “throwing budgets up that don’t fully address the problems of our veterans in this country.”
Sen. Jerry Moran, R-Kansas, told Shulkin, “I want to hear from you today, Mr. Secretary, how we can help avoid situations where you don’t have the funds needed to provide the care that veterans expect.”
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Shulkin said the 2018 VA budget is $186.5 billion – an increase of $6.4 billion or 3.6 percent over 2017 – and that the VA budgeted $200 million for 2018 to start the process of change management, which will consume the majority of EHR costs for the first two years. The 2018 budget also provides for VA’s replacement of specific systems.
The budget request also includes $358.5 million to replace the financial management system. VA will establish an Integrated Project Team to develop the requirements and acquisition strategy for a new enterprise health information platform. It will also invest $340 million for information security to protect Veterans’ information and improve VA’s information networks’ resilience, Shulkin said.
Shulkin added that VA intends to include the cost of the EHR in its 2019 budget.
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