The Department of Veterans Affairs announced in June 2017 that it was opting to follow the Department of Defense’s lead in transitioning to a new electronic health record system, with the goal of creating a truly interoperable system that could seamlessly transition service members into veterans.

But past interoperability initiatives have been fraught with poor cooperation, so the agencies created a Federal Electronic Health Record Modernization Program Office March 1, 2019, to act as the arbitrator in future EHR decisions.

According to Lauren Thompson, director of the DoD and VA’s Interagency Program Office, the FEHRM will act as the deciding authority on EHR plans.

“FEHRM leaders will have the authority to direct each department to execute joint decisions for technical, programmatic and functional functions under its purview and will provide oversight regarding required funding and policy as necessary,” said Thompson at a June 12 hearing before the House Veterans Affairs committee.

“An interim FEHRM director and deputy director will be appointed to work with the implementation team in transitioning joint functions into the FEHRM once the FEHRM has an approved charter.”

But members of the committee worried that the FEHRM’s phased implementation plan will mean that the office is not operational in time to address critical parts of the EHR development process.

Federal contractor officials told the committee the week prior that the single greatest risk to their success was the timing and the ability to make decisions.

“We are at a moment in time when critical decisions must be made in order to advance the implementation of this program. But we’re doing so without a fully functioning joint governance structure,” said Rep. Susie Lee, D-Nev.

“Based on the timeline for implementation, it appears it will come too late to address the critical decisions that must be made now.”

Both agencies plan to make major steps forward on their implementation plans in the next year.

“No one wanted the FEHRM to be stood up so late. But this is the reality: we are now four months out from the go-live date of MHS GENESIS Wave One and 10 months out from the go-live date of the VA’s initial operating capability sites. The opportunity for the FEHRM to have an impact is right now,” said Rep. Jim Banks, R-Ind.

Meanwhile, both agencies have to contend with the problems reported with the initial DoD roll-out of the new system.

To date, the FEHRM still requires the agencies to appoint an interim director and deputy director to oversee the transition of functions, get a charter approved and hire a permanent director and deputy director.

But, according to DoD and VA officials, the phased plan for setting up the FEHRM is essential to ensure the least amount of disruption to the implementation process.

“The concept that [DoD Program Executive Officer William Tinston] and I primarily worked out, the three phases concept, is a concept that was imperative to establish because it balanced where we feel our greatest risks are,” said John Windom, executive director of the VA’s Office of Electronic Health Record Modernization, who added that the incremental approach was not meant to delay the FEHRM but ensure security during the transition process.

Both agencies also plan to brief members of Congress on a more detailed plan for the FEHRM roll-out in the coming weeks.