EHR Program RESET Act of 2023

II 118TH CONGRESS 1ST SESSION S. 1125 To authorize an electronic health record modernization program of the De- partment of Veterans Affairs and increase oversight and accountability of the program to better serve veterans, medical professionals of the Department, and taxpayers, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 30, 2023 Mr. TESTER (for himself, Mrs. MURRAY, and Mr. BROWN) introduced the fol- lowing bill; which was read twice and referred to the Committee on Vet- erans’ Affairs A BILL To authorize an electronic health record modernization pro- gram of the Department of Veterans Affairs and increase oversight and accountability of the program to better serve veterans, medical professionals of the Department, and taxpayers, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Electronic Health Record Program Restructure, En- 5 hance, Strengthen, and Empower Technology Act of 6 2023’’ or the ‘‘EHR Program RESET Act of 2023’’. 7 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1125 IS (b) TABLE OF CONTENTS.—The table of contents for 1 this Act is as follows: 2 Sec. 1. Short title; table of contents. Sec. 2. Definitions. TITLE I—PROGRAM ESTABLISHMENT, STRUCTURE, MANAGEMENT, AND OBJECTIVES Sec. 101. Establishment of electronic health record and health information technology modernization program and program office of De- partment of Veterans Affairs. Sec. 102. Establishment of Department of Veterans Affairs advisory sub- committee on electronic health record and health information technology modernization. TITLE II—DEPLOYMENT CRITERIA AND THRESHOLDS TO ADVANCE Sec. 201. Requirement to exceed or meet certain health care performance base- line or national metrics for continuation of electronic health record modernization program of Department of Veterans Af- fairs. Sec. 202. Requirements before continued deployment of new electronic health record by Department of Veterans Affairs at additional loca- tions and facilities. Sec. 203. Sense of Congress on training and change management activities for deployment of new electronic health record. TITLE III—ENHANCED SUPPORT FOR HEALTH CARE AND OTHER FACILITIES DEPLOYING NEW ELECTRONIC HEALTH RECORD Sec. 301. Report on support to facilities for new electronic health record de- ployment by Department of Veterans Affairs. Sec. 302. Modification of quarterly report to include information on system sta- bility, satisfaction, morale, retention of staff, training, and change management with respect to new electronic health record of Department of Veterans Affairs. TITLE IV—CONTRACTING AND ACQUISITION OVERSIGHT AND REFORM Sec. 401. Termination of contract with Oracle Cerner for training and change management. Sec. 402. Strengthening contract negotiation by Department of Veterans Af- fairs with respect to new electronic health record and designa- tion of lead contract negotiator. Sec. 403. Independent verification and validation of certain major moderniza- tion efforts of Department of Veterans Affairs. Sec. 404. Annual report on efforts to maintain VistA electronic health record system. Sec. 405. Report on alternatives to current electronic health record technology and contract for Department of Veterans Affairs. Sec. 406. Report on leadership, acquisition, and contracting oversight lessons learned. VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1125 IS Sec. 407. Report on contract savings, services provided at no cost to the De- partment, and contract cost incurred with respect to Oracle- Cerner product. TITLE V—COORDINATION WITH DEPARTMENT OF DEFENSE Sec. 501. Quarterly reports on system uptime, modernization, and coordination activities for information technology systems and policies of Department of Defense affecting operations of Department of Veterans Affairs. Sec. 502. Coordination with Department of Defense regarding information technology programs, systems, and services. TITLE VI—OTHER MATTERS Sec. 601. Report on legislative action required. Sec. 602. Report on current and future State interoperability with legacy elec- tronic health record, new electronic health record, and future potential electronic health record and other health information technology and exchanges. SEC. 2. DEFINITIONS. 1 Except as otherwise provided, in this Act: 2 (1) APPROPRIATE COMMITTEES OF CON- 3 GRESS.—The term ‘‘appropriate committees of Con- 4 gress’’ means— 5 (A) the Committee on Veterans’ Affairs 6 and the Committee on Appropriations of the 7 Senate; and 8 (B) the Committee on Veterans’ Affairs 9 and the Committee on Appropriations of the 10 House of Representatives. 11 (2) DEPARTMENT.—The term ‘‘Department’’ 12 means the Department of Veterans Affairs. 13 (3) DEPUTY SECRETARY.—The term ‘‘Deputy 14 Secretary’’ means the Deputy Secretary of Veterans 15 Affairs. 16 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1125 IS (4) FOURTH MISSION.—The term ‘‘Fourth Mis- 1 sion’’ means the mission of the Department to im- 2 prove the preparedness of the United States for re- 3 sponse to war, terrorism, national emergency, and 4 natural disaster. 5 (5) MODERNIZATION; MODERNIZE.—The terms 6 ‘‘modernization’’ and ‘‘modernize’’, with respect to 7 the electronic health record and other relevant 8 health information technology systems of the De- 9 partment, means to replace, in whole or in part, 10 overhaul, or upgrade such record or other system in 11 a manner that gives such record or other system lon- 12 gevity and ability to constantly be updated to meet 13 the needs of veterans, employees of the Department, 14 and the Department. 15 (6) NEW ELECTRONIC HEALTH RECORD.—The 16 term ‘‘new electronic health record’’ means any elec- 17 tronic health record provided for the Department on 18 or after the date of the enactment of this Act, in- 19 cluding pursuant to a contract entered into by the 20 Department. 21 (7) ORACLE-CERNER PRODUCT.—The term 22 ‘‘Oracle-Cerner product’’ means the product pro- 23 vided under the contract entered into by the Depart- 24 ment with Cerner pursuant to the electronic health 25 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1125 IS record modernization program of the Department 1 before the date of the enactment of this Act. 2 (8) SECRETARY.—The term ‘‘Secretary’’ means 3 the Secretary of Veterans Affairs. 4 (9) UNDER SECRETARY.—The term ‘‘Under 5 Secretary’’ means the Under Secretary for Health of 6 the Department of Veterans Affairs. 7 TITLE I—PROGRAM ESTABLISH- 8 MENT, STRUCTURE, MANAGE- 9 MENT, AND OBJECTIVES 10 SEC. 101. ESTABLISHMENT OF ELECTRONIC HEALTH 11 RECORD AND HEALTH INFORMATION TECH- 12 NOLOGY MODERNIZATION PROGRAM AND 13 PROGRAM OFFICE OF DEPARTMENT OF VET- 14 ERANS AFFAIRS. 15 (a) ESTABLISHMENT OF PROGRAM.— 16 (1) ESTABLISHMENT.—There is established 17 within the Veterans Health Administration a pro- 18 gram to modernize the electronic health record and 19 other relevant health information technology systems 20 of the Department (in this section referred to as the 21 ‘‘Program’’). 22 (2) PURPOSE AND GOALS.—The purpose and 23 goals of the Program are as follows: 24 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 1125 IS (A) To deliver an electronic health record, 1 platform, and related systems that allow the 2 Department to deliver, as measured by quantifi- 3 able industry and Department-specific metrics, 4 improved standardized workflows and con- 5 sistent, quality health care to veterans through 6 a modern, user-friendly, electronic health record 7 and related systems that allow medical profes- 8 sionals of the Department to deliver health care 9 to veterans safely. 10 (B) To increase the productivity, effi- 11 ciency, retention, satisfaction, and experience of 12 such medical professionals. 13 (C) To improve veteran experience and 14 health outcomes. 15 (D) To improve quality and coordination of 16 care, reduce unnecessary variation, and improve 17 data management. 18 (E) To maintain, strengthen, and expand 19 the research and development activities of the 20 Department to include those activities required 21 under title 38, United States Code. 22 (F) To maintain and strengthen the ability 23 of the Department to carry out Fourth Mission 24 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 1125 IS requirements, to include the requirements under 1 title 38, United States Code. 2 (G) To protect the health and other per- 3 sonal identifying information of veterans from 4 being monetized, sold, or otherwise misused by 5 any internal or external entity conducting work 6 for, with, or on behalf of the Department. 7 (H) To protect the health and other per- 8 sonal identifying information of veterans or 9 other users of the electronic health record or 10 other programs or services of the Department 11 from cyber attacks, identity theft, and other 12 cyber and security threats. 13 (I) To deliver— 14 (i) operational value to the Depart- 15 ment from the use of the electronic health 16 record and related systems; 17 (ii) business value and return on in- 18 vestment to the Department from improve- 19 ment to the electronic health record and 20 related systems across all relevant do- 21 mains, to include cyber and other security, 22 business, and financial operations; and 23 (iii) an evolving level of advanced 24 interoperability of the electronic health 25 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 1125 IS record with the greatest number of elec- 1 tronic health record systems, platforms, 2 services, and related interfaces in the Fed- 3 eral, private, nonprofit, and other relevant 4 health sectors. 5 (J) To develop health information tech- 6 nology modernization strategies and implemen- 7 tation plans that provide the Department with 8 the most flexibility to continuously modernize 9 the health information technology systems of 10 the Department in an agile manner, not com- 11 mitted to any one particular vendor or vendors 12 or technology solution or solutions, commonly 13 known as ‘‘vendor lock’’, and respond to new 14 trends in the health information technology in- 15 dustry in real time, allowing for relevant and 16 appropriate integration with other health infor- 17 mation technology platforms and services. 18 (K) To aggressively manage and monitor 19 the implementation of all contracts and services 20 procured by the Department related to such 21 electronic health record and related services to 22 control cost, ensure best value, monitor, and 23 evaluate delivery of the services procured in line 24 with program goals and desired outcomes. 25 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 1125 IS (L) To carry out the purposes and goals 1 described in subparagraphs (A) through (K) at 2 the most effective short-, medium-, and long- 3 term cost to the Federal Government using in- 4 dustry and government best practices so as to 5 protect taxpayers. 6 (M) Such other purposes or goals as deter- 7 mined— 8 (i) pursuant to the report submitted 9 under subsection (b)(6); or 10 (ii) by the Secretary, the Deputy Sec- 11 retary, or the Under Secretary pursuant to 12 a report submitted to the appropriate com- 13 mittees of Congress describing any new 14 purpose or goal for the Program not later 15 than 90 days after adding such purpose or 16 goal to the Program. 17 (b) ESTABLISHMENT OF PROGRAM MANAGEMENT 18 OFFICE.— 19 (1) IN GENERAL.—There is established within 20 the Veterans Health Administration the Electronic 21 Health Record and Health Information Technology 22 Modernization Program Management Office (re- 23 ferred to in this section as the ‘‘Office’’). The Sec- 24 retary or the Deputy Secretary may rename the Of- 25 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 1125 IS fice and upon renaming such office shall notify Con- 1 gress not later than 60 days after such renaming. 2 (2) ORGANIZATIONAL LOCATION OF OFFICE.— 3 (A) IN GENERAL.—The Under Secretary 4 shall determine the appropriate organizational 5 location within the Veterans Health Adminis- 6 tration for the Office so as to align responsibil- 7 ities within existing or newly formed clinical, 8 patient safety, health informatics, finance, and 9 other business operations of the Veterans 10 Health Administration. 11 (B) REORGANIZATION OF OFFICE.—The 12 Secretary, the Deputy Secretary, and the Under 13 Secretary may move or reorganize the organiza- 14 tional location of the Office only after notifying 15 the appropriate committees of Congress not 16 later than 90 days before such move or reorga- 17 nization. 18 (3) LEADERSHIP AND STAFF.— 19 (A) EXECUTIVE DIRECTOR.—The Under 20 Secretary shall establish a leader to be respon- 21 sible for the Office, to be known as the ‘‘Execu- 22 tive Director of the Electronic Health Record 23 and Health Information Technology Moderniza- 24 tion Program Management Office’’. 25 VerDate Sep 11 2014 22:10 Apr 11, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1125.IS S1125 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 1125 IS (B) PROGRAM FUNCTIONAL CHAMPION.— 1 (i) IN GENERAL.—The Under Sec- 2 retary shall establish a Functional Cham- 3 pion of the Program who will serve with 4 the Executive Director of the Office. 5 (ii) DUTIES.—The duties of the Func- 6 tional Champion are— 7 (I) to be the lead clinical execu- 8 tive to guide and address functional 9 initiatives to support medical per- 10 sonnel of the Department in the de- 11 ployment of a new electronic health 12 record and other health information 13 technology products; and 14 (II) to carry out such additional 15 duties as the Under Secretary and the 16 Executive Director of the Office may 17 prescribe. 18 (C) OTHER OFFICES AN [Text truncated for display. 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