Item 281 (C) of the 2018 Appropriations Act directed the Secretary of Health and Human Resources, in collaboration with the Secretary of Administration and the Secretary of Public Safety and Homeland Security, to establish an interagency workgroup (“the workgroup") to oversee the development of a statewide integrated electronic health record (EHR) system. Currently, the Department of Behavioral Health and Developmental Services (DBHDS) is under contract to implement an EHR system for the state’s mental health hospitals. The Virginia Department of Corrections (VADOC) recently received funding to begin implementing an EHR system at the state’s female correctional facilities, with the intent to broaden the EHR system capability to all correctional facilities in the Commonwealth. The Virginia Department of Health (VDH) has requested but not yet received funding to implement an EHR system at all local health departments in order to improve patient care and efficiency in the public health sector. The purpose of this workgroup is to collaborate on the development of these EHR systems, to review the costs and benefits of using one vendor and product (those already under contract with DBHDS) or, alternatively, allowing the agencies to use different vendors and products as long as 1) all systems would be interoperable; and 2) agencies can access and share data on individuals receiving medical care and health care services at multiple state facilities.

The 2018 Act required the workgroup to report on its activities by October 15, 2018. The Secretary of Health and Human Resources submitted an interim report on behalf of the working group (Exhibit A). The workgroup found it difficult to provide a robust cost benefit analysis on different vendors and products because the vendors were reluctant to provide estimates in the absence of a specific procurement request. The 2019 Appropriations Act includes additional language regarding estimating the cost of implementing an EHR system through the VDH:

The workgroup shall produce a robust analysis of the costs and benefits of using the platform provided through Contract Number VA-121107-SMU managed by the Virginia Information Technologies Agency on behalf of the Commonwealth of Virginia in developing and implementing electronic health records for use by the Virginia Department of Health. The analysis shall consider the need for a separate domain from any other procured through the Contract. The workgroup shall report on the findings of the analysis and any recommendations to the Joint Subcommittee on Health and Human Resources Oversight by November 1, 2019.

Based on the language in the 2019 Appropriations Act pertaining to VADOC’s use of the same vendor and product as DBHDS, the workgroup decided the most productive route was to work with the current DBHDS vendor to obtain cost estimates. From there, the workgroup discussed strengths and limitations of the product and considered the business needs of each agency. This report includes information specific to the cost estimates for implementation of an EHR by VDH, as well as an update and costs specific to DBHDS and VADOC. The Secretaries of Administration, Health and Human Resources, and Public Safety and Homeland Security recommend the workgroup continue to meet under their direction for cost analysis and contract collaboration at the outset of the project, and for continuous coordination as the statewide EHR system is built.