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VA project funding hits hurdle in House

The House Committee on Veterans Affairs wants computer overhaul questions cleared up.

By STEPHEN NOHLGREN and PAUL DE LA GARZA
Published April 15, 2005

Worried that a computer overhaul at VA hospitals nationwide could fail, a congressional committee recommended Thursday that all funding be cut, casting doubt on the project's survival.

The Bush administration has earmarked $311-million for the program, known as HealtheVet or HeV, in its 2006 budget request. The VA estimates the project will cost $3.5-billion over 10 years.

After the St. Petersburg Times publicized a report Wednesday critical of the project, the House Committee on Veterans Affairs recommended Congress withhold all funding until "questions about serious operability problems can be resolved."

"Information technology at (the) VA is not centrally managed, and the results are poor service to veterans, inefficiency and wasted tax dollars," Indiana Republican Steve Buyer, the committee chairman, said in a written statement.

HealtheVet would revamp virtually all phases of VA hospital computing over five years or more, affecting the delivery of care to 5-million veterans. Some software development is already under way.

But a February Carnegie Mellon University study warned that the project is "not viable" and an "unacceptedly high risk" unless the VA dramatically changes its course.

"The VA must rethink HealtheVet," it said.

Among other things, the VA has inadequately assessed risks and is letting deadlines, not results, drive the project, the report said. Carnegie also criticized the VA culture, saying it discourages differing opinions.

In an interview Thursday, Robert McFarland, assistant secretary for information and technology at the Department of Veterans Affairs, said that based on Carnegie Mellon's findings, the future of HeV is under review. He declined to discuss the committee's recommendation.

McFarland, however, said discovering problems with the program early on was "good news not bad news." He said it was normal for a program the scope of HeV "to have holes in it."

Keith Ashdown of Taxpayers for Common Sense said the committee's recommendation was "virtually unprecedented" so early in the life of a major federal project. Pointing to the Carnegie study, Ashdown said there is no question that the VA has "a huge major white elephant on the horizon."

"The Veterans Affairs Committee should be commended," he said, "because they're taking unprecedented action trying to save money before the waste occurs."

Sen. Bill Nelson, D-Fla., also weighed in. "The House action is encouraging," said Nelson, who is seeking answers from the VA's chief to the questions raised by the Carnegie study. "We don't need to race, if it'll end up wasting taxpayers' money."

Members of Congress were unaware of the Carnegie Mellon study until the Times disclosed it, Rep. C.W. Bill Young, R-Indian Shores, said. The VA had refused to share the study with the House VA Committee until late Thursday, insisting it was an internal document.

The $311-million appropriation proposed for fiscal year 2006, which begins Oct. 1, is the first time the HealtheVet initiative appears as a separate line item within the VA budget.

In February, the House VA Committee proposed cutting $400-million from the VA budget. It wasn't until Thursday, however, that it publicly identified the programs it wants to cut.

The Veterans Affairs committee doesn't set the VA budget, though it is charged with recommending which programs to fund. House and Senate appropriations committees have final say. But getting approval from the House VA committee was one of the first major hurdles the project faced.

The House Appropriations Committee has launched a formal investigation of the project, based on the Carnegie findings.

McFarland, the VA technology chief, said the agency is deciding how to proceed with the HeV overhaul. He also said that the VA may not need the money it requested after all.

"We have a purely budget placeholder in there for moving forward," McFarland said. "No decision has been made to implement $311-million."

McFarland said he and Dr. Jonathan Perlin, acting undersecretary for health, would decide what to do next. "Whether I sign off on any dollars on that in '06 will be a decision made by Dr. Perlin and myself," McFarland said. "We have not decided not to go forward, I will put it to you that way."

McFarland said he requested the Carnegie Mellon assessment after a much smaller computer experiment flopped last year at Bay Pines VA Medical Center in St. Petersburg.

That project, called CoreFLS, dealt only with finances and inventory.

After months of live testing, employees struggled to order supplies and pay vendors. A scathing report by the VA's inspector general and a negative review by Carnegie Mellon prompted the VA to kill the pilot at Bay Pines.

It cost taxpayers close to $300-million.

McFarland said Carnegie Mellon's assessment of CoreFLS gave him the idea to have them look at the much more ambitious HeV program.

"I said, "Let's go back to them and get them to do a similar thing up front, at the beginning of the process so we can find out how not to have another CoreFLS,"' McFarland said.

"And I intend to do this on all our major projects so that before we go off and spend money or start writing a whole bunch of code, we know what the problems were with the plan up front."

The HeV conversion is designed to replace the VA's existing network of computer programs called VistA, which was developed over 20 years by doctors, nurses and computer wonks in the field.

It is widely admired by people who run hospitals, but VA management says it is outdated for running a huge health care system like the VA.

McFarland said that instead of launching HeV full scale he could envision "biting off" a smaller chunk of the project in the beginning.

For example, the VA could focus on four aspects of VistA that it might want to concentrate on and not the entire system, McFarland said. "We think we have a plan, we're trying to work through that, and at this point we haven't cast it in concrete," he said.

[Last modified April 15, 2005, 00:50:05]