EHR Program RESET Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 2809 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 HOUSE OF REPRESENTATIVES APRIL 24, 2023 Mr. TAKANO (for himself, Mr. BOST, Mrs. CHERFILUS-MCCORMICK, Mr. MRVAN, Mrs. DINGELL, Mr. LANDSMAN, Mrs. LEE of Nevada, Ms. SCHRIER, Mrs. RODGERS of Washington, and Mr. BALDERSON) intro- duced the following bill; which was referred to the Committee on Vet- erans’ Affairs, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the com- mittee concerned 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 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 2809 IH SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1 (a) SHORT TITLE.—This Act may be cited as the 2 ‘‘Electronic Health Record Program Restructure, En- 3 hance, Strengthen, and Empower Technology Act of 4 2023’’ or the ‘‘EHR Program RESET Act of 2023’’. 5 (b) TABLE OF CONTENTS.—The table of contents for 6 this Act is as follows: 7 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. VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 2809 IH 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. 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 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 2809 IH (2) DEPARTMENT.—The term ‘‘Department’’ 1 means the Department of Veterans Affairs. 2 (3) DEPUTY SECRETARY.—The term ‘‘Deputy 3 Secretary’’ means the Deputy Secretary of Veterans 4 Affairs. 5 (4) FOURTH MISSION.—The term ‘‘Fourth Mis- 6 sion’’ means the mission of the Department to im- 7 prove the preparedness of the United States for re- 8 sponse to war, terrorism, national emergency, and 9 natural disaster. 10 (5) MODERNIZATION; MODERNIZE.—The terms 11 ‘‘modernization’’ and ‘‘modernize’’, with respect to 12 the electronic health record and other relevant 13 health information technology systems of the De- 14 partment, means to replace, in whole or in part, 15 overhaul, or upgrade such record or other system in 16 a manner that gives such record or other system lon- 17 gevity and ability to constantly be updated to meet 18 the needs of veterans, employees of the Department, 19 and the Department. 20 (6) NEW ELECTRONIC HEALTH RECORD.—The 21 term ‘‘new electronic health record’’ means any elec- 22 tronic health record provided for the Department on 23 or after the date of the enactment of this Act, in- 24 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 2809 IH cluding pursuant to a contract entered into by the 1 Department. 2 (7) ORACLE-CERNER PRODUCT.—The term 3 ‘‘Oracle-Cerner product’’ means the product pro- 4 vided under the contract entered into by the Depart- 5 ment with Cerner pursuant to the electronic health 6 record modernization program of the Department 7 before the date of the enactment of this Act. 8 (8) SECRETARY.—The term ‘‘Secretary’’ means 9 the Secretary of Veterans Affairs. 10 (9) UNDER SECRETARY.—The term ‘‘Under 11 Secretary’’ means the Under Secretary for Health of 12 the Department of Veterans Affairs. 13 TITLE I—PROGRAM ESTABLISH- 14 MENT, STRUCTURE, MANAGE- 15 MENT, AND OBJECTIVES 16 SEC. 101. ESTABLISHMENT OF ELECTRONIC HEALTH 17 RECORD AND HEALTH INFORMATION TECH- 18 NOLOGY MODERNIZATION PROGRAM AND 19 PROGRAM OFFICE OF DEPARTMENT OF VET- 20 ERANS AFFAIRS. 21 (a) ESTABLISHMENT OF PROGRAM.— 22 (1) ESTABLISHMENT.—There is established 23 within the Veterans Health Administration a pro- 24 gram to modernize the electronic health record and 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 2809 IH other relevant health information technology systems 1 of the Department (in this section referred to as the 2 ‘‘Program’’). 3 (2) PURPOSE AND GOALS.—The purpose and 4 goals of the Program are as follows: 5 (A) To deliver an electronic health record, 6 platform, and related systems that allow the 7 Department to deliver, as measured by quantifi- 8 able industry and Department-specific metrics, 9 improved standardized workflows and con- 10 sistent, quality health care to veterans through 11 a modern, user-friendly, electronic health record 12 and related systems that allow medical profes- 13 sionals of the Department to deliver health care 14 to veterans safely. 15 (B) To increase the productivity, effi- 16 ciency, retention, satisfaction, and experience of 17 such medical professionals. 18 (C) To improve veteran experience and 19 health outcomes. 20 (D) To improve quality and coordination of 21 care, reduce unnecessary variation, and improve 22 data management. 23 (E) To maintain, strengthen, and expand 24 the research and development activities of the 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 2809 IH Department to include those activities required 1 under title 38, United States Code. 2 (F) To maintain and strengthen the ability 3 of the Department to carry out Fourth Mission 4 requirements, to include the requirements under 5 title 38, United States Code. 6 (G) To protect the health and other per- 7 sonal identifying information of veterans from 8 being monetized, sold, or otherwise misused by 9 any internal or external entity conducting work 10 for, with, or on behalf of the Department. 11 (H) To protect the health and other per- 12 sonal identifying information of veterans or 13 other users of the electronic health record or 14 other programs or services of the Department 15 from cyber attacks, identity theft, and other 16 cyber and security threats. 17 (I) To deliver— 18 (i) operational value to the Depart- 19 ment from the use of the electronic health 20 record and related systems; 21 (ii) business value and return on in- 22 vestment to the Department from improve- 23 ment to the electronic health record and 24 related systems across all relevant do- 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 2809 IH mains, to include cyber and other security, 1 business, and financial operations; and 2 (iii) an evolving level of advanced 3 interoperability of the electronic health 4 record with the greatest number of elec- 5 tronic health record systems, platforms, 6 services, and related interfaces in the Fed- 7 eral, private, nonprofit, and other relevant 8 health sectors. 9 (J) To develop health information tech- 10 nology modernization strategies and implemen- 11 tation plans that provide the Department with 12 the most flexibility to continuously modernize 13 the health information technology systems of 14 the Department in an agile manner, not com- 15 mitted to any one particular vendor or vendors 16 or technology solution or solutions, commonly 17 known as ‘‘vendor lock’’, and respond to new 18 trends in the health information technology in- 19 dustry in real time, allowing for relevant and 20 appropriate integration with other health infor- 21 mation technology platforms and services. 22 (K) To aggressively manage and monitor 23 the implementation of all contracts and services 24 procured by the Department related to such 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 2809 IH electronic health record and related services to 1 control cost, ensure best value, monitor, and 2 evaluate delivery of the services procured in line 3 with program goals and desired outcomes. 4 (L) To carry out the purposes and goals 5 described in subparagraphs (A) through (K) at 6 the most effective short-, medium-, and long- 7 term cost to the Federal Government using in- 8 dustry and government best practices so as to 9 protect taxpayers. 10 (M) Such other purposes or goals as deter- 11 mined— 12 (i) pursuant to the report submitted 13 under subsection (b)(6); or 14 (ii) by the Secretary, the Deputy Sec- 15 retary, or the Under Secretary pursuant to 16 a report submitted to the appropriate com- 17 mittees of Congress describing any new 18 purpose or goal for the Program not later 19 than 90 days after adding such purpose or 20 goal to the Program. 21 (b) ESTABLISHMENT OF PROGRAM MANAGEMENT 22 OFFICE.— 23 (1) IN GENERAL.—There is established within 24 the Veterans Health Administration the Electronic 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •HR 2809 IH Health Record and Health Information Technology 1 Modernization Program Management Office (re- 2 ferred to in this section as the ‘‘Office’’). The Sec- 3 retary or the Deputy Secretary may rename the Of- 4 fice and upon renaming such office shall notify Con- 5 gress not later than 60 days after such renaming. 6 (2) ORGANIZATIONAL LOCATION OF OFFICE.— 7 (A) IN GENERAL.—The Under Secretary 8 shall determine the appropriate organizational 9 location within the Veterans Health Adminis- 10 tration for the Office so as to align responsibil- 11 ities within existing or newly formed clinical, 12 patient safety, health informatics, finance, and 13 other business operations of the Veterans 14 Health Administration. 15 (B) REORGANIZATION OF OFFICE.—The 16 Secretary, the Deputy Secretary, and the Under 17 Secretary may move or reorganize the organiza- 18 tional location of the Office only after notifying 19 the appropriate committees of Congress not 20 later than 90 days before such move or reorga- 21 nization. 22 (3) LEADERSHIP AND STAFF.— 23 (A) EXECUTIVE DIRECTOR.—The Under 24 Secretary shall establish a leader to be respon- 25 VerDate Sep 11 2014 04:45 Jun 24, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2809.IH H2809 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •HR 2809 IH sible for the Office, to be known as the ‘‘Execu- 1 tive Director of the Electronic Health Record 2 and Health Information Technology Moderniza- 3 tion Program Management Office’’. 4 (B) PROGRAM FUNCTIONAL CHAMPION.— 5 (i) IN GENERAL.—The Under Sec- 6 retary shall establish a Functional Cham- 7 pion of the Program who will serve with 8 the Executive Director of the Office. 9 (ii) DUTIES.—The duties of the Func- 10 tional Champion are— 11 (I) to be the lead clinical execu- 12 tive to guide and address functional [Text truncated for display. 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