,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #bhji  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #bd1 #bjbc ,mr4
 ,takano 7= himself1 ,mr4 ,bo/1 ,mrs4   
,*]filus-,mc,cormick1 ,mr4 ,mrvan1 ,mrs4
 ,d+ell1 ,mr4 ,l&sman1 ,mrs4 ,lee (     
,nevada1 ,ms4 ,s*ri]1 ,mrs4 ,rodg]s (   
,wa%+ton1 & ,mr4 ,bald]son7 introduc$ ! 
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,vet]ans' ,affairs1 & 9   
addition to ! ,committee on ,arm$       
,s]vices1 = a p]iod to be subsequ5tly   
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to au?orize an electronic     
heal? record mod]nization program ( !   
,dep>tm5t ( ,vet]ans ,affairs & increase
 ov]sight & acc\ntability ( ! program to
 bett] s]ve vet]ans1 m$ical pr(essionals
 ( ! ,dep>tm5t1 & taxpay]s1 & = o!r     
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,electronic ,heal? ,record  
,program ,re/ructure1 ,enhance1 ,/r5g!n1

 & ,emp[] ,te*nology ,act ( #bjbc or !  
,,ehr ,program ,,reset ,act ( #bjbc4    
7b7 ,table ( cont5ts ,! table ( cont5ts 
= ?is ,act is z foll[s3  ,sec4 #a4 ,%ort
 title2 table ( cont5ts4 ,sec4 #b4      
,def9itions4 ,,title ,i--,program       
e/abli%m5t1 /ructure1 managem5t1 &      
objectives ,sec4 #aja4 ,e/abli%m5t (    
electronic heal? record & heal?         
in=mation te*nology mod]nization program
 & program (fice ( ,dep>tm5t ( ,vet]ans 
,affairs4 ,sec4 #ajb4 ,e/abli%m5t (     
,dep>tm5t ( ,vet]ans ,affairs advisory  
subcommittee on electronic heal? record 
& heal? in=mation te*nology             
mod]nization4 ,,title ,,ii--,deploym5t  
crit]ia & ?re%olds to advance ,sec4     
#bja4 ,requirem5t to exce$ or meet c]ta9
 heal? c>e p]=mance basel9e or national 
metrics = cont9uation ( electronic heal?
 record mod]nization program ( ,dep>tm5t
 ( ,vet]ans ,affairs4 ,sec4 #bjb4       
,requirem5ts be=e cont9u$ deploym5t (   
new electronic heal? record by ,dep>tm5t
 ( ,vet]ans ,affairs at additional      

locations & facilities4 ,sec4 #bjc4     
,s5se ( ,congress on tra9+ & *ange      
managem5t activities = deploym5t ( new  
electronic heal? record4 ,,title        
,,iii--,enhanc$ support = heal? c>e &   
o!r facilities deploy+ new electronic   
heal? record ,sec4 #cja4 ,report on     
support to facilities = new electronic  
heal? record deploym5t by ,dep>tm5t (   
,vet]ans ,affairs4 ,sec4 #cjb4          
,modification ( qu>t]ly report to       
include in=mation on sy/em /ability1    
satisfaction1 morale1 ret5tion ( /aff1  
tra9+1 & *ange managem5t ) respect to   
new electronic heal? record ( ,dep>tm5t 
( ,vet]ans ,affairs4 ,,title            
,,iv--,contract+ & acquisition ov]sight 
& re=m ,sec4 #dja4 ,t]m9ation ( contract
 ) ,oracle ,c]n] = tra9+ & *ange        
managem5t4 ,sec4 #djb4 ,/r5g!n+ contract
 negotiation by ,dep>tm5t ( ,vet]ans    
,affairs ) respect to new electronic    
heal? record & designation ( lead       
contract negotiator4 ,sec4 #djc4        
,indep5d5t v]ification & validation (   

c]ta9 major mod]nization ef=ts (        
,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#djd4 ,annual report on ef=ts to ma9ta9 
,vist,a electronic heal? record sy/em4  
,sec4 #dje4 ,report on alt]natives to   
curr5t electronic heal? record te*nology
 & contract = ,dep>tm5t ( ,vet]ans      
,affairs4 ,sec4 #djf4 ,report on        
lead]%ip1 acquisition1 & contract+      
ov]sight lessons le>n$4 ,sec4 #djg4     
,report on contract sav+s1 s]vices      
provid$ at no co/ to ! ,dep>tm5t1 &     
contract co/ incurr$ ) respect to       
,oracle-,c]n] product4 ,,title          
,v--,coord9ation ) ,dep>tm5t ( ,def5se  
,sec4 #eja4 ,qu>t]ly reports on sy/em   
uptime1 mod]nization1 & coord9ation     
activities = in=mation te*nology sy/ems 
& policies ( ,dep>tm5t ( ,def5se affect+
 op]ations ( ,dep>tm5t ( ,vet]ans       
,affairs4 ,sec4 #ejb4 ,coord9ation )    
,dep>tm5t ( ,def5se reg>d+ in=mation    
te*nology programs1 sy/ems1 & s]vices4  
,,title ,,vi--,o!r matt]s ,sec4 #fja4   
,report on legislative action requir$4  

,sec4 #fjb4 ,report on curr5t & future  
,/ate int]op]ability ) legacy electronic
 heal? record1 new electronic heal?     
record1 & future pot5tial electronic    
heal? record & o!r heal? in=mation      
te*nology & ex*anges4  #b4 ,def9itions  
,except z o!rwise provid$1 9 ?is ,act3  
7#a7 ,appropriate committees ( ,congress
 ,! t]m appropriate committees (        
,congress means--  7,a7 ! ,committee on 
,vet]ans' ,affairs & ! ,committee on    
,appropriations ( ! ,s5ate2 &  7,b7 !   
,committee on ,vet]ans' ,affairs & !    
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives4  7#b7 ,dep>tm5t ,!   
t]m ,dep>tm5t means ! ,dep>tm5t (       
,vet]ans ,affairs4  7#c7 ,deputy        
,secret>y ,! t]m ,deputy ,secret>y means
 ! ,deputy ,secret>y ( ,vet]ans         
,affairs4  7#d7 ,f\r? ,mission ,! t]m   
,f\r? ,mission means ! mission ( !      
,dep>tm5t to improve ! prep>$ness ( !   
,unit$ ,/ates = response to w>1         
t]rorism1 national em]g5cy1 & natural   
disa/]4  7#e7 ,mod]nization2 mod]nize ,!

 t]ms mod]nization & mod]nize1 ) respect
 to ! electronic heal? record & o!r     
relevant heal? in=mation te*nology      
sy/ems ( ! ,dep>tm5t1 means to replace1 
9 :ole or 9 "p1 ov]haul1 or upgrade su* 
record or o!r sy/em 9 a mann] t gives   
su* record or o!r sy/em longevity &     
ability to con/antly be updat$ to meet !
 ne$s ( vet]ans1 employees ( !          
,dep>tm5t1 & ! ,dep>tm5t4  7#f7 ,new    
electronic heal? record ,! t]m new      
electronic heal? record means any       
electronic heal? record provid$ = !     
,dep>tm5t on or aft] ! date ( ! enactm5t
 ( ?is ,act1 includ+ pursuant to a      
contract ent]$ into by ! ,dep>tm5t4     
7#g7 ,oracle-,c]n] product ,! t]m       
,oracle-,c]n] product means ! product   
provid$ "u ! contract ent]$ into by !   
,dep>tm5t ) ,c]n] pursuant to !         
electronic heal? record mod]nization    
program ( ! ,dep>tm5t be=e ! date ( !   
enactm5t ( ?is ,act4  7#h7 ,secret>y ,! 
t]m ,secret>y means ! ,secret>y (       
,vet]ans ,affairs4  7#i7 ,"u ,secret>y  

,! t]m ,"u ,secret>y means ! ,"u        
,secret>y = ,heal? ( ! ,dep>tm5t (      
,vet]ans ,affairs4  ,i ,program         
e/abli%m5t1 /ructure1 managem5t1 &      
objectives  #aja4 ,e/abli%m5t (         
electronic heal? record & heal?         
in=mation te*nology mod]nization program
 & program (fice ( ,dep>tm5t ( ,vet]ans 
,affairs  7a7 ,e/abli%m5t ( program     
7#a7 ,e/abli%m5t ,!re is e/abli%$ )9 !  
,vet]ans ,heal? ,adm9i/ration a program 
to mod]nize ! electronic heal? record & 
o!r relevant heal? in=mation te*nology  
sy/ems ( ! ,dep>tm5t 79 ?is section     
ref]r$ to z ! ,program74  7#b7 ,purpose 
& goals ,! purpose & goals ( ! ,program 
are z foll[s3  7,a7 ,to deliv] an       
electronic heal? record1 plat=m1 &      
relat$ sy/ems t all[ ! ,dep>tm5t to     
deliv]1 z measur$ by quantifiable       
indu/ry & ,dep>tm5t-specific metrics1   
improv$ /&>diz$ workfl[s & consi/5t1    
quality heal? c>e to vet]ans ?r\gh a    
mod]n1 us]-fri5dly1 electronic heal?    
record & relat$ sy/ems t all[ m$ical    

pr(essionals ( ! ,dep>tm5t to deliv]    
heal? c>e to vet]ans safely4  7,b7 ,to  
increase ! productivity1 effici5cy1     
ret5tion1 satisfaction1 & exp]i5ce ( su*
 m$ical pr(essionals4  7,c7 ,to improve 
vet]an exp]i5ce & heal? outcomes4  7,d7 
,to improve quality & coord9ation ( c>e1
 r$uce unnecess>y v>iation1 & improve   
data managem5t4  7,e7 ,to ma9ta91       
/r5g!n1 & exp& ! rese>* & developm5t    
activities ( ! ,dep>tm5t to include ^?  
activities requir$ "u title #ch1 ,unit$ 
,/ates ,code4  7,f7 ,to ma9ta9 & /r5g!n 
! ability ( ! ,dep>tm5t to c>ry out     
,f\r? ,mission requirem5ts1 to include !
 requirem5ts "u title #ch1 ,unit$ ,/ates
 ,code4  7,g7 ,to protect ! heal? & o!r 
p]sonal id5tify+ in=mation ( vet]ans f  
be+ monetiz$1 sold1 or o!rwise misus$ by
 any int]nal or ext]nal entity conduct+ 
"w =1 )1 or on behalf ( ! ,dep>tm5t4    
7,h7 ,to protect ! heal? & o!r p]sonal  
id5tify+ in=mation ( vet]ans or o!r us]s
 ( ! electronic heal? record or o!r     
programs or s]vices ( ! ,dep>tm5t f cyb]

 attacks1 id5tity !ft1 & o!r cyb] &     
security ?reats4  7,i7 ,to deliv]-- 7i7 
op]ational value to ! ,dep>tm5t f ! use 
( ! electronic heal? record & relat$    
sy/ems2  7ii7 bus9ess value & return on 
inve/m5t to ! ,dep>tm5t f improvem5t to 
! electronic heal? record & relat$      
sy/ems across all relevant doma9s1 to   
include cyb] & o!r security1 bus9ess1 & 
f9ancial op]ations2 &  7iii7 an evolv+  
level ( advanc$ int]op]ability ( !      
electronic heal? record ) ! greate/     
numb] ( electronic heal? record sy/ems1 
plat=ms1 s]vices1 & relat$ int]faces 9 !
 ,f$]al1 private1 nonpr(it1 & o!r       
relevant heal? sectors4  7,j7 ,to       
develop heal? in=mation te*nology       
mod]nization /rategies & implem5tation  
plans t provide ! ,dep>tm5t ) ! mo/     
flexibility to cont9u\sly mod]nize !    
heal? in=mation te*nology sy/ems ( !    
,dep>tm5t 9 an agile mann]1 n committ$  
to any "o p>ticul> v5dor or v5dors or   
te*nology solution or solutions1        
commonly kn[n z v5dor lock1 & respond to

 new tr5ds 9 ! heal? in=mation te*nology
 indu/ry 9 real "t1 all[+ = relevant &  
appropriate integration ) o!r heal?     
in=mation te*nology plat=ms & s]vices4  
7,k7 ,to aggressively manage & monitor !
 implem5tation ( all contracts & s]vices
 procur$ by ! ,dep>tm5t relat$ to su*   
electronic heal? record & relat$ s]vices
 to control co/1 ensure be/ value1      
monitor1 & evaluate deliv]y ( ! s]vices 
procur$ 9 l9e ) program goals & desir$  
outcomes4  7,l7 ,to c>ry out ! purposes 
& goals describ$ 9 subp>agraphs 7,a7    
?r\gh 7,k7 at ! mo/ effective %ort-1    
m$ium-1 & long-t]m co/ to ! ,f$]al      
,gov]nm5t us+ indu/ry & gov]nm5t be/    
practices s z to protect taxpay]s4  7,m7
 ,su* o!r purposes or goals z det]m9$-- 
7i7 pursuant to ! report submitt$ "u    
subsection 7b77#f72 or  7ii7 by !       
,secret>y1 ! ,deputy ,secret>y1 or ! ,"u
 ,secret>y pursuant to a report submitt$
 to ! appropriate committees ( ,congress
 describ+ any new purpose or goal = !   
,program n lat] ?an #ij days aft] add+  

su* purpose or goal to ! ,program4  7b7 
,e/abli%m5t ( ,program ,managem5t ,(fice
  7#a7 ,9 g5]al ,!re is e/abli%$ )9 !   
,vet]ans ,heal? ,adm9i/ration !         
,electronic ,heal? ,record & ,heal?     
,in=mation ,te*nology ,mod]nization     
,program ,managem5t ,(fice 7ref]r$ to 9 
?is section z ! ,(fice74 ,! ,secret>y or
 ! ,deputy ,secret>y may r5ame ! ,(fice 
& ^u r5am+ su* (fice %all notify        
,congress n lat] ?an #fj days aft] su*  
r5am+4  7#b7 ,organizational location ( 
,(fice  7,a7 ,9 g5]al ,! ,"u ,secret>y  
%all det]m9e ! appropriate              
organizational location )9 ! ,vet]ans   
,heal? ,adm9i/ration = ! ,(fice s z to  
align responsibilities )9 exi/+ or newly
 =m$ cl9ical1 pati5t safety1 heal?      
in=matics1 f9ance1 & o!r bus9ess        
op]ations ( ! ,vet]ans ,heal?           
,adm9i/ration4  7,b7 ,reorganization (  
(fice ,! ,secret>y1 ! ,deputy ,secret>y1
 & ! ,"u ,secret>y may move or          
reorganize ! organizational location ( !
 ,(fice only aft] notify+ ! appropriate 

committees ( ,congress n lat] ?an #ij   
days be=e su* move or reorganization4   
7#c7 ,lead]%ip & /aff  7,a7 ,executive  
,director ,! ,"u ,secret>y %all e/abli% 
a lead] to be responsible = ! ,(fice1 to
 be kn[n z ! ,executive ,director ( !   
,electronic ,heal? ,record & ,heal?     
,in=mation ,te*nology ,mod]nization     
,program ,managem5t ,(fice4  7,b7       
,program ,functional ,*ampion  7i7 ,9   
g5]al ,! ,"u ,secret>y %all e/abli% a   
,functional ,*ampion ( ! ,program :o w  
s]ve ) ! ,executive ,director ( !       
,(fice4  7ii7 ,duties ,! duties ( !     
,functional ,*ampion are--  7,i7 to be !
 lead cl9ical executive to guide &      
address functional initiatives to       
support m$ical p]sonnel ( ! ,dep>tm5t 9 
! deploym5t ( a new electronic heal?    
record & o!r heal? in=mation te*nology  
products2 &  7,,ii7 to c>ry out su*     
additional duties z ! ,"u ,secret>y & ! 
,executive ,director ( ! ,(fice may     
prescribe4  7,c7 ,o!r (fices & positions
  7i7 ,9 g5]al ,! ,"u ,secret>y %all    

direct ! e/abli%m5t ( v>i\s o!r relevant
 sub-(fices & positions = ! ,(fice z !  
,"u ,secret>y consid]s necess>y draw+ ^u
 be/ practices f ! ,dep>tm5t1 !         
,dep>tm5t ( ,def5se1 & o!r gov]nm5t1    
private sector1 & nonpr(it models &     
develop an organizational model tailor$ 
to ! ,dep>tm5t = bus9ess & managem5t    
effectiv5ess4  7ii7 ,types ( sub-(fices 
,at a m9imum1 )9 ! ,(fice !re %all be   
(fices d$icat$ to--  7,i7 tra9+2  7,,ii7
 *ange managem5t2  7,,iii7              
communications2  7,,iv7 field support2  
7,v7 contract task ord] developm5t1     
monitor+1 & ov]sight2  7,,vi7 metrics1  
p]=mance1 & value2 &  7,,vii7 quality & 
safety4  7iii7 ,s5se ( ,congress ,x is !
 s5se ( ,congress t--  7,i7 ! ,dep>tm5t 
%\ld develop a model "u clause 7i7 t is 
driv5 by be/ practices f gov]nm5t &     
indu/ry b n replicate = ! sake (        
replication /ructures us$ by ! ,dep>tm5t
 ( ,def5se or else:]e t d n factor 9 !  
pati5t population1 unique mission1 ,f\r?
 ,mission requirem5ts1 & rese>*         

requirem5ts ( ! ,dep>tm5t1 & o!r        
relevant factors2 &  7,,ii7 ! /ructure (
 su* model %\ld be driv5 by ! objectives
 ( ! ,(fice & ! desir$ end /ate to      
improve value & quality ( c>e & heal?   
outcomes = vet]ans :ile improv+ provid] 
effici5cy & productivity & op]ations ( !
 ,dep>tm5t4  7#d7 ,function & duties    
7,a7 ,function ,! function ( ! ,(fice   
%all be1 ) respect to all aspects ( !   
mod]nization or replacem5t ( !          
electronic heal? record & o!r key heal? 
in=mation te*nology & s]vices ( !       
,dep>tm5t-- 7i7 to develop & execute    
/rategy 9 coord9ation ) relevant (fices 
& entities ( ! ,dep>tm5t2 &  7ii7 to    
p]=m managem5t1 ov]sight1 &             
acc\ntability1 includ+ ov] all          
contracts1 coord9ation1 plann+1         
managem5t1 & implem5tation4  7,b7       
,duties ,! duties ( ! ,(fice %all       
include ! foll[+3  7i7 ,ensur+ !        
,program deliv]s ! tools m$ical         
pr(essionals ( ! ,dep>tm5t ne$ to safely
 deliv] c>e to vet]ans :ile increas+    

productivity1 satisfaction1 & effici5cy 
z measur$ by metrics4  7ii7 ,organiz+   
all ( ! relevant heal?1 bus9ess1        
in=matics1 & relat$ (fices ( ! ,vet]ans 
,heal? ,adm9i/ration to ensure a        
coord9at$ /rategy reg>d+ ! new          
electronic heal? record & o!r curr5t &  
future key heal? in=mation te*nology &  
s]vices ( ! ,dep>tm5t4  7iii7 ,coord9at+
 ) o!r (fices & entities ( ! ,dep>tm5t )
 key dep5d5cies & responsibilities 9 !  
success ( ! ,program or op]ational ne$s 
= ! s]vices ( ! ,program1 includ+ !     
,(fice ( ,in=mation & ,te*nology1 !     
,vet]ans ,b5efits ,adm9i/ration1 & o!r  
relevant (fices4  7iv7 ,ensur+ !        
/ability & security ( ! new electronic  
heal? record & o!r curr5t & future key  
heal? in=mation te*nology & s]vices ( ! 
,dep>tm5t4  7v7 ,ov]sight ( "w p]=m$ by 
contractors reg>d+ su* record1          
te*nology1 & s]vices4  7vi7 ,develop+ a 
heal? in=mation te*nology /rategy ( !   
,dep>tm5t--  7,i7 to increase quality ( 
c>e1 heal? outcomes1 & exp]i5ce ( c>e   

receiv$ by vet]ans2  7,,ii7 to increase 
value to bus9ess & heal? op]ations ( !  
,dep>tm5t2  7,,iii7 to enable ! fur!r   
recruitm5t & ret5tion ( m$ical          
pr(essionals2 &  7,,iv7 to coh]5tly     
def9e h[ disp>ate heal? in=mation       
te*nology ef=ts ( ! ,dep>tm5t c be      
align$ to deliv] on t /rategy ) concrete
 goals1 metrics1 & outcomes4  7vii7     
,develop+ goals1 key p]=mance           
indicators1 & metrics to evaluate su*   
record1 te*nology1 & s]vices1 includ+ ) 
respect to f9ancial p]=mance1 provid]   
productivity1 & heal? p]=mance4  7viii7 
,monitor+ su* goals1 p]=mance           
indicators1 & metrics to develop actions
 = :5 su* goals1 p]=mance indicators1 & 
metrics h n be5 met4  7ix7 ,improvem5t (
 bus9ess op]ations ( ! ,dep>tm5t relat+ 
to su* record1 te*nology1 & s]vices4    
7x7 ,su* o!r matt]s z ! ,secret>y1 !    
,deputy ,secret>y1 or ! ,"u ,secret>y   
consid] appropriate4  7#e7 ,report on   
e/abli%m5t ( ,(fice  7,a7 ,9 g5]al ,n   
lat] ?an #ij days aft] ! date ( !       

enactm5t ( ?is ,act1 ! ,deputy          
,secret>y1 ! ,"u ,secret>y1 & ! ,*ief   
,in=mation ,(fic] ( ! ,dep>tm5t %all    
submit to ! appropriate committees (    
,congress a s+le report outl9+ !        
e/abli%m5t ( ! ,(fice & its curr5t      
/r5g?s & weaknesses4  7,b7 ,elem5ts ,!  
report requir$ "u subp>agraph 7,a7 %all 
include--  7i7 a cle> articulation ( !  
objective ( ! ,program & h[ t objective 
is ti$ to ! broad] heal? in=mation      
te*nology mod]nization /rategy & heal?  
c>e mission ( ! ,dep>tm5t1 :i* %all     
include functional & te*nical quality   
/&>ds to def9e success ( ! ,program bas$
 on cle> demon/ration ( improv$ heal? & 
bus9ess op]ational metrics2  7ii7 a     
/rategy describ+ h[ te*nology procur$ by
 ! ,dep>tm5t %all be "p ( a compreh5sive
 approa* = us+ heal? in=mation          
te*nology1 models ( c>e deliv]y1 &      
rese>* conduct$ by ! ,dep>tm5t to /r5g!n
 s]vices = vet]ans & vet]an engagem5t2  
7iii7 concrete /eps = h[ ! ,dep>tm5t w  
use int]nal & ext]nal res\rces to       

op]ationalize ! /rategy "u clause 7ii7  
?r\gh te*nical & functional eng9e]+     
exp]tise to /reaml9e ! organization &   
gov]nance ( ! ,(fice ( ,in=mation &     
,te*nology1 ! ,vet]ans ,heal?           
,adm9i/ration1 & o!r relevant (fices or 
entities ( ! ,dep>tm5t to enact t       
/rategy2  7iv7 an assessm5t ( ! curr5t &
 desir$ future /ate1 ) timel9es to      
a*ieve su* future /ate1 ( ent]prise     
bus9ess & te*nical ar*itecture1         
in=mation te*nology product             
consolidation & managem5t1 in=mation    
te*nology gov]nance1 bus9ess & cl9ical  
process /&>dization & quality control ( 
! ,dep>tm5t & ! /eps t are or w be tak5 
9 response to t assessm5t1 includ+ a    
timel9e = execution ( ^? re=ms2 &  7v7 a
 description1 z ( ! date ( ! report1 ( !
 curr5t /atus ( ! objectives ( ! ,(fice1
 :e!r ^? objectives are be+ met1 & if !y
 are n be+ met ! /eps ! ,dep>tm5t w     
take1 includ+ a timel9e1 to a*ieve ^?   
objectives4  7c7 ,deputy ,*ief          
,in=mation ,(fic] = ,electronic ,heal?  

,record & ,heal? ,in=mation ,te*nology  
7#a7 ,e/abli%m5t ,!re is e/abli%$ )9 !  
,(fice ( ,in=mation & ,te*nology ( !    
,dep>tm5t a ,deputy ,*ief ,in=mation    
,(fic] = ,electronic ,heal? ,record &   
,heal? ,in=mation ,te*nology :o %all be 
acc\ntable = all te*nical implem5tation 
( ! mod]nization ( ! electronic heal?   
record & heal? in=mation te*nology1 9   
coord9ation ) ! ,program & ! ,(fice4    
7#b7 ,r5am+ ,! ,*ief ,in=mation ,(fic] (
 ! ,dep>tm5t may r5ame ! position       
e/abli%$ "u p>agraph 7#a7 & ^u r5am+ su*
 position %all notify ,congress n lat]  
?an #ij days aft] su* r5am+4  7#c7 ,*a9 
( comm& ,! ,deputy ,*ief ,in=mation     
,(fic] = ,electronic ,heal? ,record &   
,heal? ,in=mation ,te*nology ( !        
,dep>tm5t %all report to ! ,*ief        
,in=mation ,(fic] & ! ,assi/ant         
,secret>y = ,in=mation & ,te*nology ( ! 
,dep>tm5t4  7#d7 ,duties ,! ,deputy     
,*ief ,in=mation ,(fic] = ,electronic   
,heal? ,record & ,heal? ,in=mation      
,te*nology ( ! ,dep>tm5t %all be        

responsible = organiz+ all functions ( !
 ,(fice ( ,in=mation & ,te*nology ( !   
,dep>tm5t to support ! mod]nization ( ! 
electronic heal? record & heal?         
in=mation te*nology ( ! ,dep>tm5t1      
includ+ cyb] security1 sy/em /ability & 
uptime1 sy/em p]=mance1 & integration ) 
relevant plat=ms1 sy/ems1 & s]vices1    
includ+ ^? ( ! ,dep>tm5t ( ,def5se & o!r
 ,f$]al ag5cies4  7#e7 ,additional      
guidance ,! ,*ief ,in=mation ,(fic] ( ! 
,dep>tm5t may provide additional or     
modifi$ guidance = ! role ( ,deputy     
,*ief ,in=mation ,(fic] = ,electronic   
,heal? ,record & ,heal? ,in=mation      
,te*nology ( ! ,dep>tm5t4  7d7          
,adm9i/rative matt]s  7#a7              
,acc\ntability & ov]sight = program ,!  
,deputy ,secret>y %all be ! acc\ntable  
(ficial = ! ,program1 ov]see ! ,program1
 & may direct res\rces1 subject to      
appropriations1 ?r\gh\t ! ,dep>tm5t1    
p>ticul>ly to ! ,vet]ans ,heal?         
,adm9i/ration & ! ,(fice ( ,in=mation & 
,te*nology ( ! ,dep>tm5t1 to facilitate 

successful plann+1 managem5t1 ov]sight1 
& execution ( ! ,program4  7#b7         
,responsibility = program & (fice ,! ,"u
 ,secret>y %all be ! responsible (ficial
 = ! ,program & ! ,(fice1 work+ toge!r )
 ! ,executive ,director ( ! ,(fice4 ,!  
,"u ,secret>y & ! ,executive ,director (
 ! ,(fice %all be directly responsible &
 9 *>ge ( ! daily "w ( ! ,program & !   
,(fice4  7#c7 ,track+ & report+ ( funds 
,any funds direct$ by ! ,deputy         
,secret>y to o!r entities ( ! ,dep>tm5t 
to support ! ,program or ! ,(fice %all  
be track$ & report$ z fall+ "u !        
,program reg>dless ( ! (fice t manages &
 executes ^? p>ticul> funds4  #ajb4     
,e/abli%m5t ( ,dep>tm5t ( ,vet]ans      
,affairs advisory subcommittee on       
electronic heal? record & heal?         
in=mation te*nology mod]nization  7a7 ,9
 g5]al ,n lat] ?an #fj days aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,secret>y1   
act+ 9 coord9ation ) & ?r\gh ! ,"u      
,secret>y1 %all e/abli% a p]man5t       
subcommittee ( ! special m$ical advisory

 gr\p e/abli%$ "u section #gcab ( title 
#ch1 ,unit$ ,/ates ,code1 focus$ on     
electronic heal? record & heal?         
in=mation te*nology mod]nization ( !    
,dep>tm5t1 to be kn[n z ! ,subcommittee 
on ,electronic ,heal? ,record & ,heal?  
,in=mation ,te*nology ,mod]nization 79  
?is section ref]r$ to z !               
,subcommittee74  7b7 ,composition (     
,subcommittee  7#a7 ,9 g5]al ,!         
,subcommittee %all be compos$ ( n few]  
?an #e & n m ?an #aj individuals select$
 by ! ,"u ,secret>y :o h a curr5t or    
previ\s docum5t$ & relevant deep        
pr(essional backgr\nd )9 a lead+ heal?  
c>e organization or organizations ( !   
,unit$ ,/ates 9 ! private or nonpr(it   
heal? sector1 includ+-- 7,a7 exp]i5ce ) 
heal? sy/ems2  7,b7 exp]i5ce z a heal?  
executive1 *ief heal? in=mation or      
in=matics (fic]1 *ief m$ical in=mation  
(fic]1 cl9ician1 or nurse ) deep        
exp]i5ce implem5t+ or ov]see+ m$ium- or 
l>ge-scale heal? in=mation te*nology    
trans=mation1 includ+ electronic heal?  

record deploym5ts & bus9ess             
mod]nizations2  7,c7 exp]i5ce improv+   
heal? c>e outcomes2  7,d7 exp]i5ce      
manag+ *ange2 or  7,e7 exp]i5ce 9       
develop+ & implem5t+ electronic heal?   
record tra9+4  7#b7 ,nurse or nurse     
executive ,at lea/ "o memb] ( !         
,subcommittee %all be a nurse or nurse  
executive4  7#c7 ,memb] ( vet]ans s]vice
 organization ,at lea/ "o memb] ( !     
,subcommittee %all be a repres5tative ( 
a ,f$]ally *>t]$1 memb]%ip-bas$ vet]ans 
s]vice organization4  7#d7 ,limitation  
,an individual is n eligible to be a    
memb] ( ! ,subcommittee if !            
individual-- 7,a7 is f ! in=mation      
te*nology v5dor or te*nology developm5t 
sector2 or  7,b7 _h a role 9 ! ,oracle  
or ,c]n] procurem5t by ! ,dep>tm5t or   
relat$ contracts = program managem5t    
s]vices = ! electronic heal? record     
mod]nization program ( ! ,dep>tm5t4  7c7
 ,duties ,! ,subcommittee %all produce  
p]iodic reports & recomm5dations z      
direct$ or reque/$ by ! ,secret>y or !  

,"u ,secret>y on plans & opportunities =
 ! ,dep>tm5t to improve its /rategy1    
goals1 & implem5tation = & deploym5t (  
electronic heal? records & heal?        
in=mation te*nology to bett] improve    
quality ( c>e1 pati5t outcomes1         
op]ational effici5cy & productivity1    
provid] productivity & engagem5t1 &     
relat$ matt]s bas$ on national be/      
practices t are relevant to ! ,dep>tm5t4
  7d7 ,adm9i/ration ,adm9i/ration ( !   
,subcommittee1 includ+ t]ms ( s]vice &  
replacem5t ( memb]s1 %all be guid$ by ! 
rules & *>t] ( ! special m$ical advisory
 gr\p e/abli%$ "u section #gcab ( title 
#ch1 ,unit$ ,/ates ,code4  7e7          
,t]m9ation ,?is section %all t]m9ate on 
! date on :i* ! ,secret>y det]m9es t a  
mod]niz$ electronic heal? record has be5
 deploy$ to e m$ical c5t] & o!r relevant
 m$ical facility ( ! ,dep>tm5t4  ,,ii   
,deploym5t crit]ia & ?re%olds to advance
  #bja4 ,requirem5t to exce$ or meet    
c]ta9 heal? c>e p]=mance basel9e or     
national metrics = cont9uation (        

electronic heal? record mod]nization    
program ( ,dep>tm5t ( ,vet]ans ,affairs 
7a7 ,9 g5]al ,! ,secret>y may n initiate
 a new g-live deploym5t ( ! electronic  
heal? record mod]nization program until 
! quality1 access1 productivity1 & all  
o!r heal? & op]ational p]=mance metrics 
data ( ! ,vet]ans ,heal? ,adm9i/ration &
 ! ,(fice ( ,in=mation & ,te*nology ( ! 
,dep>tm5t at ea* facility ( ! ,dep>tm5t 
7includ+ any subsidi>y facilities1 su* z
 community-bas$ outpati5t cl9ics7 t is  
us+ ! ,oracle-,c]n] product "u su*      
program z ( ,janu>y #ca1 #bjbc1 has     
ei!r-- 7#a7 exce$$ ! heal? & in=mation  
te*nology op]ational levels ( ! facility
 be=e deploy+ su* product2 or  7#b7 met 
national /&>ds set =? by ! ,vet]ans     
,heal? ,adm9i/ration = quality1 safety1 
effici5cy1 & f9ancial p]=mance z        
e/abli%$ by ! ,program e/abli%$ "u      
section #aja7;a7 & ! ,"u ,secret>y4  7b7
 ,e/abli%m5t ( national /&>ds  7#a7 ,9  
g5]al ,! ,"u ,secret>y & ! ,program     
e/abli%$ "u section #aja7;a7 %all       

e/abli% national /&>ds requir$ "u       
subsection 7a77#b7 to create a common   
heal? p]=mance /&>d ( ! ,vet]ans ,heal? 
,adm9i/ration "u :i* all m$ical         
facilities ( ! ,dep>tm5t may be evaluat$
 "u t subsection t takes into acc\nt    
relevant diff]5ces 9 size1 complexity1 &
 m>ket ( ea* facility4  7#b7 ,common    
metric & /&>d ,9 e/abli%+ /&>ds "u      
p>agraph 7#a71 ! ,"u ,secret>y & !      
,program e/abli%$ "u section #aja7;a7   
%all e/abli% a common data driv5 metric 
& s]vice deliv]y /&>d = c>e = vet]ans by
 :i* m$ical facilities ( ! ,dep>tm5t c  
be evaluat$4  7#c7 ,reports  7,a7       
,initial report ,n lat] ?an #fj days    
aft] ! e/abli%m5t ( /&>ds "u p>agraph   
7#a71 ! ,program e/abli%$ "u section    
#aja7;a7 %all submit to ! appropriate   
committees ( ,congress a report on su*  
/&>ds4  7,b7 ,modification to /&>ds ,n  
lat] ?an #cj days be=e ! modification to
 any /&>ds e/abli%$ "u p>agraph 7#a71 ! 
,program e/abli%$ "u section #aja7;a7   
%all submit to ! appropriate committees 

( ,congress a report on su*             
modification4  7c7 ,t]m9ation or        
cont9uation ( use  7#a7 ,9 g5]al ,if1 by
 ! date t is #ahj days aft] ! date ( !  
enactm5t ( ?is ,act1 ! data f ! fir/    
five facilities ( ! ,dep>tm5t z well z  
any relevant remote sites1 consolidat$  
pati5t acc\nt c5t]s1 subsidi>y          
facilities1 su* z community-bas$        
outpati5t cl9ics t deploy$ !            
,oracle-,c]n] product1 h n rea*$ !      
requirem5ts "u subsection 7a7--  7,a7 n 
lat] ?an #ac mon?s aft] su* date (      
enactm5t1 ! ,secret>y1 9 consultation ) 
! ,deputy ,secret>y1 ! ,"u ,secret>y =  
,heal?1 ! ,*ief ,in=mation ,(fic]1 & !  
,executive ,director ( ! ,(fice1 %all-- 
7i7 submit to ! appropriate committees (
 ,congress a plan on h[ ! ,dep>tm5t w   
meet ! requirem5ts "u su* subsection    
ei!r ?r\gh ! exi/+ te*nology /rategy ( !
 ,dep>tm5t1 a new procurem5t1 or "s o!r 
comb9ation or approa*2 &  7ii7 publicly 
ann\nce a replacem5t te*nology solution 
or solutions or contract or contracts1  

includ+ a new timel9e & /rategy to      
implem5t su* solution or solutions2     
7,b7 n lat] ?an #ahj days aft] complet+ 
! requirem5ts "u subp>agraph 7,a71 !    
,secret>y %all--  7i7 t]m9ate1 cancel1  
or modify ! contract = ! ,oracle-,c]n]  
product2 &  7ii7 develop appropriate    
coord9ation & transition plans = !      
transition ( use ( te*nology f !        
,oracle-,c]n] product back to ,vist,a or
 f ! ,oracle-,c]n] product to an        
alt]nate electronic heal? record        
te*nology4  7#b7 ,limitation on         
cancellation ( exi/+ contract ,9 c>ry+  
out p>agraph 7#a71 to ensure a smoo?    
transition & r$uce op]ational & c>e     
deliv]y di/urbance1 ! ,secret>y may n   
t]m9ate any exi/+ electronic heal?      
record contract until a replacem5t      
contract & /rategy = su* electronic     
heal? record are 9 place or ne> aw>d &  
comm5cem5t4  7#c7 ,ext5sion ( "t  7,a7  
,9 g5]al ,n lat] ?an #abj days aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y may1 = "o "t only1 tempor>ily 

delay ea* ( ! requirem5ts ( p>agraph    
7#a7 = a p]iod n to exce$ #ahj days if !
 ,secret>y det]m9es su* delay is        
necess>y due to mission critical1       
national em]g5cy1 national security1    
pati5t safety1 quality & access to c>e1 
protection ( taxpay] inve/m5ts1 or o!r  
un=ese5 reasons4  7,b7 ,ju/ification =  
ext5sion ,if ! ,secret>y det]m9es t a   
delay "u subp>agraph 7,a7 is necess>y1 n
 lat] ?an #aje days aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ! appropriate committees (    
,congress a report sett+ =? !           
ju/ification ( ! ,secret>y = su* delay4 
#bjb4 ,requirem5ts be=e cont9u$         
deploym5t ( new electronic heal? record 
by ,dep>tm5t ( ,vet]ans ,affairs at     
additional locations & facilities  7a7  
,report on metrics ,to det]m9e cont9u$  
deploym5t  7#a7 ,9 g5]al ,n lat] ?an #cj
 days aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,deputy ,secret>y %all submit to
 ! appropriate committees ( ,congress a 
report conta9+ ! metrics1 read9ess      

crit]ia1 & gov]nance decision process t 
! ,dep>tm5t w use to det]m9e :e!r       
cont9u$ deploym5t ( ! electronic heal?  
record te*nology ( ! ,dep>tm5t is       
appropriate 9 ,june #bjbc1 or :e!r a    
fur!r pause 9 su* deploym5t is w>rant$  
to address sy/em issues1 pati5t safety1 
te*nology features1 provid] effici5cy1 &
 relat$ matt]s4  7#b7 ,metrics ,!       
metrics includ$ 9 ! report submitt$ "u  
p>agraph 7#a7 %all-- 7,a7 be data driv5 
bas$ on indu/ry /&>ds1 metrics ( !      
,dep>tm5t1 & ! unique heal? c>e deliv]y 
ne$s ( ! ,dep>tm5t to s]ve vet]ans1 p]=m
 rese>*1 & support ,f\r? ,mission       
requirem5ts2  7,b7 ensure pati5t safety1
 quality ( & access to c>e1 sy/em       
/ability1 cyb] security1 & s\nd f9ancial
 & bus9ess adm9i/ration activities are  
successfully evaluat$ z /able &         
functional at desir$ p]=mance levels & 9
 place to proce$2  7,c7 ensure          
completion ( relevant tra9+ & *ange     
managem5t activities2 &  7,d7 include   
any o!r specific read9ess crit]ia t ea* 

location ( ! ,dep>tm5t is requir$ to    
meet be=e mov+ =w>d ) cont9u$ deploym5t 
( ! electronic heal? record te*nology ( 
! ,dep>tm5t1 z det]m9$ by ! ,dep>tm5t4  
7#c7 ,o!r elem5ts ,! report submitt$ "u 
p>agraph 7#a7 %all--  7,a7 indicate h[ !
 metrics requir$ "u ! report are or w be
 adju/$ to incorporate ! rese>* function
 & heal? complexity levels ( facilities 
( ! ,dep>tm5t & :e!r additional or      
diff]5t metrics are or w be add$ bas$ on
 m or less complex facilities or        
facilities ) a great] rese>* function2  
7,b7 expla9 h[ ! metrics & read9ess     
crit]ia "u ! report incorporate         
appropriate input & f9d+s ( ! ,national 
,c5t] = ,pati5t ,safety1 ! ,cl9ical     
,episode ,review ,team1 or ! ,(fice ( ! 
,assi/ant ,"u ,secret>y = ,heal? =      
,quality & ,pati5t ,safety ( ! ,vet]ans 
,heal? ,adm9i/ration1 or any successor  
(fice1 & resolve any issues rais$ by ^? 
(fices to ! satisfaction ( ^? (fices    
?r\gh in=mation te*nology *anges1       
functionality1 tra9+1 & o!r areas1      

includ+ reg>d+ pati5t record flags1     
behavioral heal? & suicide risks1       
configuration ( roles &                 
responsibilities1 ref]rals1 ambulatory  
c>e1 ph>macy1 id5tity1 ord]s1 m$ication 
adm9i/ration1 & o!r areas1 :i* %all     
include a specific description ( h[ ea* 
issue id5tifi$ 9 ! ,m>* #bjbc report ( !
 ,dep>tm5t entitl$1 ,,ehrm ,spr9t       
,report has be5 resolv$ or mitigat$2 &  
7,c7 provide a cle> process description 
reflect+-- 7i7 ! repeatable me?od = h[  
decisions relat+ to deploym5t (         
electronic heal? record te*nology are   
made )9 ! ,dep>tm5t f ! field level up  
to ! ,secret>y2 &  7ii7 ! input receiv$ 
f ea* relevant elem5t ( ! ,dep>tm5t be=e
 su* a decision is made1 to include     
input f ! ,national ,c5t] = ,pati5t     
,safety4  7#d7 ,c]tification ,9 submitt+
 metrics "u p>agraph 7#a71 ! ,deputy    
,secret>y %all c]tify t ! metrics h be5 
approv$ by ! ,"u ,secret>y1 ! ,executive
 ,director ( ! ,(fice1 & ! ,*ief        
,in=mation ,(fic] ( ! ,dep>tm5t4  #bjc4 

,s5se ( ,congress on tra9+ & *ange      
managem5t activities = deploym5t ( new  
electronic heal? record ,x is ! s5se (  
,congress t-- 7#a7 tra9+ & *ange        
managem5t ) respect to any new          
electronic heal? record %all be l$ by ! 
,dep>tm5t & employees ( ! ,dep>tm5t :o  
are uniquely position$ to und]/& !      
legacy ,vist,a sy/em ( ! ,dep>tm5t1 !   
exi/+ & future /&>diz$ workfl[ ( !      
,dep>tm5t1 & ! hi/ory1 culture1 &       
mission ( ! ,dep>tm5t2 &  7#b7 any      
contractors ( ! ,dep>tm5t involv$ 9 !   
implem5tation ( any new electronic heal?
 record %\ld s]ve 9 a support function  
to ! ,dep>tm5t r ?an lead & conduct all 
tra9+ & *ange managem5t activities4     
,,iii ,enhanc$ support = heal? c>e & o!r
 facilities deploy+ new electronic heal?
 record  #cja4 ,report on support to    
facilities = new electronic heal? record
 deploym5t by ,dep>tm5t ( ,vet]ans      
,affairs  7a7 ,9 g5]al ,n lat] ?an #ij  
days aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,deputy ,secret>y %all submit to

 ! appropriate committees ( ,congress a 
report summ>iz+ ! /&>d support s]vices t
 ! ,dep>tm5t does or int5ds to provide  
to ea* facility 9 prep>ation = pot5tial 
future deploym5t ( ! new electronic     
heal? record ( ! ,dep>tm5t at su*       
facility & 9 ! p]iod aft] su* deploym5t4
  7b7 ,support ,to be provid$ ,! support
 requir$ to be provid$ to a facility by 
! ,dep>tm5t & includ$ 9 ! report "u     
subsection 7a7 %all include1 at a       
m9imum1 ! foll[+3 7#a7 ,budget>y        
res\rces & support to address ! ne$ =   
increas$ /aff+ at ! facility1 r$uc$     
productivity & collections1 increas$ use
 ( community c>e networks1 & o!r issues 
id5tifi$ 9 ! report ( ! ,in/itute =     
,def5se ,analyses dat$ ,octob] #bjbb1   
entitl$ ,indep5d5t ,co/ ,e/imate =      
,vet]ans ,affairs ,electronic ,heal?    
,record ,mod]nization ,program4  7#b7   
,increas$ /aff+ level surge at !        
facility1 includ+ tempor>y & p]man5t    
/aff4  7#c7 ,/eps to be tak5 by !       
,dep>tm5t to r$uce burn\t & turnov]4    

7#d7 ,enhanc$ tra9+ to include gov]nm5t 
or v5dor suppli$ tra9]s to ma9ta9 a     
pres5ce until dismiss$ by ! director or 
o!r relevant lead] ( ! facility aft]    
deploym5t ( ! new electronic heal?      
record4  7#e7 ,a description ( any      
additional legislative action reque/$ to
 improve ! level ( support s]vices      
requir$ at ea* su* facility = su*       
deploym5t4  7#f7 ,su* o!r support z !   
,deputy ,secret>y det]m9es necess>y 9   
consultation ) ! ,"u ,secret>y1 !       
,executive ,director ( ! ,electronic    
,heal? ,record & ,heal? ,in=mation      
,te*nology ,mod]nization ,program       
,managem5t ,(fice1 & ! ,*ief ,in=mation 
,(fic]4  #cjb4 ,modification ( qu>t]ly  
report to include in=mation on sy/em    
/ability1 satisfaction1 morale1 ret5tion
 ( /aff1 tra9+1 & *ange managem5t )     
respect to new electronic heal? record (
 ,dep>tm5t ( ,vet]ans ,affairs ,section 
#ejc7;b7 ( ! ,vet]ans ,b5efits &        
,transition ,act ( #bjah 7,public ,law  
#aae-djg2 #ch ,u4,s4,c4 #egja note      

prec47 is am5d$--  7#a7 by r$esignat+   
p>agraphs 7#a7 ?r\gh 7#f7 z subp>agraphs
 7,a7 ?r\gh 7,f71 respectively1 & mov+  
^? subp>agraphs1 z s r$esignat$1 two ems
 to ! "r2  7#b7 9 ! matt] prec$+        
subp>agraph 7,a71 z designat$ by        
p>agraph 7#a71 by /rik+ ,n lat] ?an #cj 
days & ins]t+ ! foll[+3  7#a7 ,9 g5]al  
,n lat] ?an #cj days  2 &  7#c7 by add+ 
at ! end ! foll[+ new p>agraph3  7#b7   
,additional matt]s ,to be includ$  7,a7 
,9 g5]al ,! ,secret>y %all include ) any
 update submitt$ "u p>agraph 7#a7 on or 
aft] ! date ( ! enactm5t ( ! ,electronic
 ,heal? ,record ,program ,re/ructure1   
,enhance1 ,/r5g!n1 & ,emp[] ,te*nology  
,act ( #bjbc1 ) respect to ! qu>t] cov]$
 by ! report1 ! foll[+3 7i7 ,data on    
employee satisfaction ) ! new electronic
 heal? record ( ! ,dep>tm5t ( ,vet]ans  
,affairs us+ cr$ible1 indu/ry /&>d      
surveys & data analysis4  7ii7 ,data on 
ret5tion1 morale1 & turnov] at sites us+
 su* new record4  7iii7 ,data on        
satisfaction ) tra9+ & *ange managem5t  

activities provid$ to employees &       
facilities ( ! ,dep>tm5t reg>d+ su*     
record4  7iv7 ,data on ticket resolution
 & closure4  7v7 ,! specific sy/em      
enhancem5ts to include configuration    
*anges & new s]vice reque/s t h be5 te/$
 & put into production = electronic     
heal? record sy/em us]s & a li/ &       
description ( rema9+ configuration      
*anges & new s]vice reque/s "u          
developm5t or 9 requirem5ts developm5t &
 ! e/imat$ date = su* improvem5ts to be 
te/$ & put into production = electronic 
heal? record sy/em us]s4  7vi7 ,! sy/em 
p]=mance /ati/ics = su* record1 to      
include-- 7,i7 cause1 l5g?1 & s\rce ( or
 responsible entity = p]=mance issues2 &
  7,,ii7 corrective /eps tak5 to rectify
 outages1 p]=mance degradations1        
incomplete functionality1 & loss (      
r$undancy4  7vii7 ,! heal? op]ations1   
productivity1 & quality metrics ( ea*   
facility us+ su* new record z ( ! end ( 
! qu>t] cov]$ by ! report comp>$ to !   
heal? op]ations1 productivity1 & quality

 metrics ( t facility be=e deploym5t ( !
 new record :ile us+ ! legacy ,vist,a & 
relat$ sy/ems & comp>$ to ! national    
quality & access /&>ds e/abli%$ by !    
,vet]ans ,heal? ,adm9i/ration to        
evaluate p]=mances ( m$ical facilities  
"u section #bja7;b7 ( ! ,electronic     
,heal? ,record ,program ,re/ructure1    
,enhance1 ,/r5g!n1 & ,emp[] ,te*nology  
,act ( #bjbc4  7viii7 ,rev5ue1          
collections1 & all o!r f9ancial data at 
facilities us+ su* new record1 includ+  
an assessm5t ( plann$ v]sus actual      
rev5ue & collections & /eps tak5 to     
rem$iate p]=mance *all5ges z well z a   
comp>ison to rev5ue1 collections1 & all 
o!r f9ancial data collect$ be=e ! new   
record 0 9 use4  7ix7 ,a description ( !
 numb] ( cure notices1 lett]s ( conc]n1 
& o!r relevant corrective contract+     
actions tak5 by ! ,dep>tm5t1 ! responses
 to ^? actions by relevant contractor or
 contractors & any cr$its1              
reimbursem5ts1 or o!r relevant repaym5t 
or corrective action agre$ ^u or issu$ &

 ! dates1 purposes1 & reasons = issuance
 ( su* cure notices1 lett]s ( conc]n1 & 
o!r relevant reque/s = corrective       
actions & ! /atus or resolution ( ^?    
matt]s4  7,b7 ,compilation ( in=mation  
,! in=mation provid$ "u subp>agraph 7,a7
 %all be-- 7i7 compil$ 9 a mann] t %[s !
 in=mation ov] "t1 at ! facility level &
 aggregat$ = all facilities2  7ii7      
compil$ us+ indu/ry-bas$ que/ions1      
/&>ds1 & metrics2 &  7iii7 in=m$ by !   
unique vet]an c>e deliv]y s]vices &     
functions ( ! ,dep>tm5t4  4  ,,iv       
,contract+ & acquisition ov]sight & re=m
  #dja4 ,t]m9ation ( contract ) ,oracle 
,c]n] = tra9+ & *ange managem5t  7a7 ,9 
g5]al ,n lat] ?an #bge days aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,secret>y    
%all-- 7#a7 t]m9ate all contracts ( !   
,dep>tm5t ) ,oracle ,c]n] = tra9+ &     
*ange managem5t relat$ to electronic    
heal? record mod]nization2 &  7#b7 cease
 to issue task ord]s = tra9+ & *ange    
managem5t activities f ,oracle ,c]n] or 
subcontractors ( ,oracle ,c]n]4  7b7    

,replacem5t ( s]vices ,be=e t]m9at+ all 
contracts ( ! ,dep>tm5t ) ,oracle ,c]n] 
z requir$ "u subsection 7a77#a71 !      
,secret>y1 z ! ,secret>y det]m9es       
necess>y & consi/5t ) section #bjc ( ?is
 ,act1 %all put plans 9 place to replace
 ! s]vices provid$ "u ^? contracts ) a  
new contract or contracts1 competitively
 procur$1 ) companies ) a prov5         
track-record 9 deliv]+ electronic heal? 
record & heal? in=mation te*nology tra9+
 & *ange managem5t 9 m$ium or l>ge heal?
 sy/ems 9 ! ,unit$ ,/ates4  7c7 ,report 
,n lat] ?an #bjj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ! appropriate committees (    
,congress a report on ! implem5tation ( 
?is section4  #djb4 ,/r5g!n+ contract   
negotiation by ,dep>tm5t ( ,vet]ans     
,affairs ) respect to new electronic    
heal? record & designation ( lead       
contract negotiator  7a7 ,designation ( 
lead negotiator = new electronic heal?  
record  7#a7 ,9 g5]al ,! ,secret>y %all 
designate "o s5ior c>e] (ficial ( !     

,dep>tm5t1 at grade ,,gs-#ae ( ! ,g5]al 
,s*$ule or an equival5t or high] grade1 
z ! lead negotiator = ! ,dep>tm5t on all
 curr5t & future contracts relat+ to !  
new electronic heal? record ( !         
,dep>tm5t 79 ?is section ref]r$ to z !  
,negotiator74  7#b7 ,organization ,!    
,negotiator %all reside )9 ! ,(fice (   
,acquisition1 ,logi/ics1 & ,con/ruction 
( ! ,dep>tm5t & report to ! ,*ief       
,acquisition ,(fic] ( ! ,dep>tm5t4  7#c7
 ,notification ,n lat] ?an #ae days aft]
 designat+ ! ,negotiator "u p>agraph    
7#a71 ! ,secret>y %all notify !         
appropriate committees ( ,congress ( su*
 designation4  7b7 ,objective (         
negotiations ,! goal ( contract         
negotiations & activities conduct$ by ! 
,negotiator ) respect to contracts      
relat+ to ! new electronic heal? record 
( ! ,dep>tm5t are1 at a m9imum-- 7#a7 to
 ensure t any future contracts or task  
ord]s = su* a record1 includ+           
modifications ( exi/+ contracts or new  
aw>ds1 %all--  7,a7 seek to protect !   

int]e/ ( taxpay]s to ! greate/ ext5t    
practicable2 &  7,b7 recov]1 by :atev]  
means available1 direct & indirect co/s 
t ! ,dep>tm5t & vet]ans h already       
incurr$ due to pati5t h>m1 poor         
p]=mance1 inadequate tra9+1 insuffici5t 
ticket resolution1 sy/em cra%es1        
ineffici5t processes driv5 by new       
te*nology1 extra ,dep>tm5t p]sonnel     
h\rs1 & o!r factors relat+ to ! use ( ! 
,oracle-,c]n] product2  7#b7 to consid] 
options to descope exi/+ contracts &    
secure disc\nt$ rates on future "w &    
su/a9m5t "w2  7#c7 to a*ieve aggressive 
indu/ry /&>d s]vice-level agreem5ts &   
significant f9ancial p5alties = failure 
to meet ^? /&>ds2  7#d7 to contractually
 codify ! s]vices1 te*nology features1 &
 o!r elem5ts t h be5 v]bally (f]$ to !  
,dep>tm5t at no co/ by a contractor or  
contractors relat$ to su* new record2   
7#e7 to develop an organiz$ & prop]ly   
phas$ contract cancellation1 transition1
 & replacem5t /rategy %\ld !            
negotiations n result 9 be/ value t]ms =

 ! taxpay]1 vet]ans1 & m$ical p]sonnel (
 ! ,dep>tm5t2 &  7#f7 to address issues 
( conflict+ or duplicative contract+    
requirem5ts to include ^? betwe5        
contractors deploy+ v>i\s aspects ( su* 
new record & ! program managem5t (fice  
contract1 includ+ pot5tial conflicts (  
int]e/ & p]v]se inc5tives = "o set (    
contractors to inhibit or sl[ ! "w ( o!r
 contractors = pot5tial f9ancial ga9 &  
lev]age = curr5t & future "w = !        
,dep>tm5t4  7c7 ,coord9ation (          
activities ,! ,negotiator %all closely  
coord9ate ) individuals 9 ! ,program & !
 ,(fice e/abli%$ "u section #aja :o h   
day-to-day responsibility = exi/+       
contract ov]sight ) respect to heal?    
record contracts & relevant heal?       
in=mation te*nology contracts4  7d7     
,consultation ,! ,negotiator %all       
lev]age & consult ) all relevant        
/akehold]s ( ! ,dep>tm5t1 b at a m9imum 
! ,secret>y1 ! ,deputy ,secret>y1 !     
,(fice ( ,g5]al ,c\nsel1 ! ,"u          
,secret>y1 & ! ,*ief ,in=mation ,(fic] &

 ! ,assi/ant ,secret>y = ,in=mation &   
,te*nology ( ! ,dep>tm5t1 9 conduct+    
negotiations relat+ to ! electronic     
heal? record ( ! ,dep>tm5t4  7e7        
,assi/ance  7#a7 ,o!r ,f$]al ag5cies ,9 
conduct+ negotiations relat+ to ! new   
electronic heal? record ( ! ,dep>tm5t1 !
 ,negotiator or ! ,secret>y may reque/  
assi/ance f ! o!r ,f$]al ag5cies t h    
exp]i5c$ contract negotiators1 legal    
c\nsel1 litigators1 & o!r relevant      
p]sonnel1 p>ticul>ly ^? ) specialties & 
exp]i5ce 9 heal? in=mation te*nology    
acquisitions1 contracts1 negotiations1 &
 litigation4  7#b7 ,outside entities    
7,a7 ,9 g5]al ,9 conduct+ negotiations1 
! ,negotiator or ! ,secret>y may engage 
non-,f$]al1 private sector1 or nonpr(it 
entities to p]=m indep5d5t contract &   
legal advisory s]vices = ! ,dep>tm5t s z
 to advise ! ,dep>tm5t on options &     
/rategies to a*ieve a revis$1 modifi$1  
or new contract = a new electronic heal?
 record t is ( bett] value to ! taxpay] 
or :]e necess>y = appropriate           

cancellation t]ms & transition plann+4  
7,b7 ,types ( entities ,9 procur+       
s]vices "u subp>agraph 7,a71 !          
,negotiator & ! ,secret>y--  7i7 %all   
only engage ) entities t h a prov51     
long-t]m exp]i5ce 9 deliv]+ value &     
resolution to entities ?r\gh high-doll> 
contracts1 agreem5ts1 settlem5ts1 or    
litigation /ructur$ to deliv] p]=mance1 
acc\ntability1 & value to taxpay]s1     
gov]nm5ts1 or cli5ts1 z ! case may be2 &
  7ii7 %all n engage ) a company t works
 = ,oracle1 ,oracle ,c]n]1 or any       
subcontractor ( ei!r su* company4  7f7  
,t]ms relat+ to protection ( data ,any  
contract ( ! ,dep>tm5t relat$ to        
electronic heal? records ent]$ into on  
or aft] ,janu>y #a1 #bjah1 %all include 
a clause or clauses1 or be modifi$ to   
include su* clause or clauses1 protect+ 
! heal? & o!r p]sonal id5tify+ data (   
vet]ans to include a total prohibition  
on t data be+ monetiz$1 sold1 controll$1
 or o!rwise misus$ by any int]nal or    
ext]nal entity conduct+ "w =1 )1 or on  

behalf ( ! ,dep>tm5t1 includ+ data t has
 gone ?r\gh anonymization4  #djc4       
,indep5d5t v]ification & validation (   
c]ta9 major mod]nization ef=ts (        
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,contract+ au?ority ,n lat] ?an #ij days
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,*ief ,acquisition ,(fic] ( ! ,dep>tm5t 
( ,vet]ans ,affairs e/abli%$ pursuant to
 section #agjb ( title #da1 ,unit$      
,/ates ,code1 %all ent] into a contract 
) an eligible entity "u subsection 7b7  
to c>ry out ! ov]sight functions        
describ$ 9 subsection 7c74  7b7         
,eligibility ,an entity is eligible "u  
?is subsection if ! ,*ief ,acquisition  
,(fic] ( ! ,dep>tm5t det]m9es t1 )      
respect to ! solicitation by ! ,dep>tm5t
 = a contract "u subsection 7a71 !      
entity-- 7#a7 is curr5tly p]=m+ or has  
p]=m$1 dur+ ! ?ree-ye> p]iod prec$+ !   
date ( ! issuance ( su* solicitation1 n 
few] ?an ?ree prime contracts = !       
indep5d5t v]ification & validation1 or  
equival5t te*nical & program ov]sight   

support1 ( major def5se acquisition     
programs or priority def5se bus9ess     
sy/ems1 9 accordance ) guidance ( !     
,dep>tm5t ( ,def5se relat+ to su*       
acquisition programs or su* bus9ess     
sy/ems2 &  7#b7 is n curr5tly p]=m+ &   
has n p]=m$1 = at lea/ ! five-ye> p]iod 
prec$+ ! date ( ! issuance ( su*        
solicitation1 any contract or           
subcontract = ! ,dep>tm5t ( ,vet]ans    
,affairs 7includ+ su* a contract or     
subcontract relat+ to a cov]$ program74 
7c7 ,functions ,! ov]sight functions    
describ$ 9 ?is subsection are ! foll[+3 
7#a7 ,conduct+ an initial assessm5t (   
ea* cov]$ program & submitt+ to !       
,secret>y a report conta9+ ! f9d+s ( su*
 assessm5t4  7#b7 ,on an annual basis1  
conduct+ an ov]all assessm5t ( ea* cov]$
 program & submitt+ to ! ,secret>y a    
report conta9+ ! f9d+s ( ea* su*        
assessm5t4  7#c7 ,conduct+ cont9u\s     
ov]sight ( ! activities c>ri$ out "u1 & 
! sy/ems associat$ )1 ea* cov]$ program1
 includ+ ov]sight ( ! /atus1 compliance1

 p]=mance1 & implem5tation (            
recomm5dations ) respect to1 = ea* cov]$
 program1 ! foll[+3 7,a7 ,managem5t1    
includ+ gov]nance1 co/s1 & implem5tation
 mile/ones & timel9es4  7,b7 ,contracts 
= implem5tation1 includ+ f9ancial       
metrics & p]=mance b5*m>ks =            
contractors4  7,c7 ,effect on !         
functions1 bus9ess op]ations1 or cl9ical
 organizational /ructure ( ! heal? c>e  
sy/em ( ! ,dep>tm5t4  7,d7 ,supply *a9  
risk managem5t1 controls1 & compliance4 
7,e7 ,data managem5t4  7,f7 ,) respect  
to associat$ sy/ems1 ! foll[+3 7i7      
,te*nical ar*itectural design1          
developm5t1 & /ability ( ! sy/ems4  7ii7
 ,sy/em int]op]ability & integration )  
relat$ in=mation te*nology sy/ems4      
7iii7 ,sy/em te/+4  7iv7 ,functional    
sy/em tra9+ provid$ to us]s4  7v7 ,sy/em
 adoption & use4  7d7 ,submission to    
,congress ,n lat] ?an #cj days aft] !   
date on :i* ! ,secret>y receives any    
annual report "u subsection 7c77#b71 !  
,secret>y %all submit to ! ,committee on

 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives su* report4  7e7
 ,aw>d$ am\nts ,n lat] ?an #ij days aft]
 ! date on :i* ! ,*ief ,acquisition     
,(fic] ( ! ,dep>tm5t ent]s into !       
contract "u subsection 7a71 ! ,*ief     
,f9ancial ,(fic] ( ! ,dep>tm5t1 9       
coord9ation ) ! heads ( su* (fice ( !   
,dep>tm5t responsible = ! managem5t ( a 
cov]$ program1 %all ensure t am\nts     
aw>d$ to an eligible entity "u su*      
contract are d]iv$1 9 proportionate     
am\nts1 f am\nts o!rwise au?oriz$ to be 
appropriat$ = ea* su* (fice ( !         
,dep>tm5t1 respectively4  7f7           
,def9itions ,9 ?is section3 7#a7 ,cov]$ 
program ,! t]m cov]$ program means !    
foll[+3  7,a7 ,! electronic heal? record
 mod]nization program 7or any successor 
program74  7,b7 ,! ,f9ancial ,managem5t 
& ,bus9ess ,trans=mation ,program 7or   
any successor program74  7,c7 ,any      
program ( ! ,dep>tm5t relat+ to supply  
*a9 mod]nization4  7,d7 ,any program ( !

 ,dep>tm5t relat+ to ! mod]nization (   
in=mation te*nology sy/ems associat$ )  
human res\rces4  7,e7 ,any program ( !  
,dep>tm5t relat+ to ! ,vet]ans ,b5efits 
,managem5t ,sy/em4  7#b7 ,priority      
def5se bus9ess sy/em ,! t]m priority    
def5se bus9ess sy/em has ! mean+ giv5   
su* t]m 9 section #bbbb7;i7 ( title #aj1
 ,unit$ ,/ates ,code4  7#c7 ,major      
def5se acquisition program ,! t]m major 
def5se acquisition program has ! mean+  
giv5 su* t]m 9 section #dbja ( title    
#aj1 ,unit$ ,/ates ,code4  #djd4 ,annual
 report on ef=ts to ma9ta9 ,vist,a      
electronic heal? record sy/em  7a7 ,9   
g5]al ,n lat] ?an #fj days aft] ! date (
 ! enactm5t ( ?is ,act1 & n lat] ?an #ij
 days aft] ! beg9n+ ( ea* fiscal ye>    
!reaft]1 ! ,secret>y %all submit to !   
appropriate committees ( ,congress a    
report on ! ,vist,a sy/em us$ by !      
,dep>tm5t4  7b7 ,elem5ts ,! report      
requir$ by subsection 7a7 %all include !
 foll[+3 7#a7 ,! co/ to ma9ta9 & /r5g!n 
! ,vist,a sy/em = ea* ( fiscal ye>s     

#bjah ?r\gh #bjbb1 = fund+ relat+ to bo?
 developm5t & op]ations & ma9t5ance4    
7#b7 ,! project$ co/ to ma9ta9 & /r5g!n 
su* sy/em = fiscal ye> #bjbc1 = fund+   
relat+ to bo? developm5t & op]ations &  
ma9t5ance4  7#c7 ,! project$ co/ to     
ma9ta9 & /r5g!n su* sy/em = ea* ( fiscal
 ye>s #bjbd ?r\gh #bjcc1 = fund+ relat+ 
to bo? developm5t & op]ations &         
ma9t5ance4  7#d7 ,! plann$ enhancem5ts  
und]way to /r5g!n & secure ! ,vist,a    
sy/em until its features & modules are  
no long] ne$$ by ! ,dep>tm5t ?r\gh su*  
sy/em1 or h be5 subsum$ or replac$ by   
o!r programs & in=mation te*nology      
s]vices & sy/ems1 includ+ cyb] security 
enhancem5ts1 movem5t to ! cl\d1 & new   
features & s]vices4  7#e7 ,a li/ (      
modules or features ( ! ,vist,a sy/em t 
are n plann$ to be replac$1 subsum$1 or 
o!rwise incorporat$ into a new          
electronic heal? record or o!r heal?    
in=mation te*nology & are plann$ to     
reside 9 a remnant ,vist,a sy/em1 or    
successor remnant sy/em4  7c7 ,initial  

report ,! fir/ report requir$ by        
subsection 7a7 %all include a           
description ( any enhancem5ts to !      
,vist,a sy/em t h occurr$ dur+ ! "o-ye> 
p]iod prec$+ ! date ( ! report & ^?     
plann$ = ! fiscal ye> 9 :i* ! report is 
submitt$4  7d7 ,subsequ5t reports ,ea*  
report aft] ! fir/ report requir$ by    
subsection 7a7 %all include a           
description ( any enhancem5ts to !      
,vist,a sy/em t h occurr$ dur+ fiscal   
ye> imm$iately prec$+ ! date ( ! report1
 ^? plann$1 b n implem5t$ & an          
explanation = su* lack ( implem5tation &
 ^? plann$ = ! fiscal ye> 9 :i* ! report
 is submitt$4  7e7 ,t]m9ation ,?is      
section %all t]m9ate on ! date t is #ae 
ye>s aft] ! date ( ! enactm5t ( ?is     
,act4  #dje4 ,report on alt]natives to  
curr5t electronic heal? record te*nology
 & contract = ,dep>tm5t ( ,vet]ans      
,affairs  7a7 ,9 g5]al ,n lat] ?an #fj  
days aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y %all submit to !      
appropriate committees ( ,congress a    

report on pa?s ! ,dep>tm5t & ,congress  
%\ld consid] to a*ieve a mod]niz$       
electronic heal? record z an alt]native 
to ! ,oracle-,c]n] product4  7b7        
,elem5ts ,! report requir$ "u subsection
 7a7 %all include ! foll[+ ) respect to 
an alt]native pa? or pa?s to be consid]$
 by ! ,dep>tm5t & ,congress3 7#a7       
,consid]ations = & aga9/ su* alt]native 
pa? or pa?s4  7#b7 ,accurate re9ve/m5t  
analysis ( exp5ditures1 develop$        
consi/5t ) co/ e/imation & o!r relevant 
guidance issu$ by ! ,comptroll] ,g5]al (
 ! ,unit$ ,/ates1 already made on !     
mod]niz$ electronic heal? record z ( !  
date ( ! report1 includ+ an assessm5t ( 
:i* ( ^? exp5ditures w\ld h to be made  
aga9 & :i* w\ld n bas$ on an alt]native 
te*nology & contract pa? *os5 & !       
ability to repurpose inve/m5ts4  7#c7 ,!
 capabilities & weaknesses ( o!r        
te*nology solutions ! ,dep>tm5t c\ld    
pursue1 includ+ an assessm5t ( long-t]m 
value & return on inve/m5t f a heal?    
deliv]y1 heal? quality1 & op]ational    

p]spective1 & ! acquisition process t   
c\ld be us$ to procure su* solutions4   
7#d7 ,an analysis ( electronic heal?    
record & heal? in=mation te*nology m>ket
 tr5ds1 capabilities1 & m>ket lead]s to 
include us] satisfaction & heal? outcome
 /ati/ics to ! ext5t !y are relevant to 
! goals & /rategy ( ! ,dep>tm5t4  7#e7  
,an analysis ( :e!r ! ,dep>tm5t *oos+ an
 alt]native pa? or pa?s w\ld1 & to :at  
ext5t1 or w\ld n impact necess>y        
alignm5t ) ! electronic heal? record    
mod]nization conduct$ by ! ,dep>tm5t (  
,def5se commonly kn[n z ,,mhs ,,g5esis4 
7#f7 ,an analysis ( :e!r ! ability to   
%>e & ex*ange records 9 an int]op]able  
mann]1 & ) :at level ( int]op]ability1 )
 ! ,dep>tm5t ( ,def5se w\ld be          
negatively impact$ or positively        
enhanc$1 or nei!r1 by an alt]native     
te*nology pa? or contract4  7#g7 ,an    
analysis ( :e!r ! ability %>e & ex*ange 
records 9 an int]op]able mann]1 & ) :at 
level ( int]op]ability1 ) non-,f$]al    
heal? entities w\ld be negatively       

impact$ or positively enhanc$1 or nei!r1
 by an alt]native te*nology pa? or      
contract4  7#h7 ,an e/imat$ timel9e to  
re/>t deploym5t ( a new electronic heal?
 record ( ! ,dep>tm5t ) a diff]5t v5dor 
bas$ on an alt]native te*nology pa? or  
contract4  7#i7 ,an assessm5t ( options 
t may include--  7,a7 a n>r[ or descop$ 
contract supplem5t$ by o!r contracts to 
/r5g!n areas 9 :i* ! ,oracle-,c]n]      
product p]=ms 9 a sub/&>d fa%ion or is  
inadequate to ! heal? deliv]y &         
op]ational ne$s ( ! ,dep>tm5t2 or  7,b7 
any o!r comb9ation ( possibilities4     
7#aj7 ,an analysis ( ! /r5g?s &         
weaknesses ( ! alt]native pa? or pa?s   
t[>ds ! ,dep>tm5t meet+ or exce$+ !     
highe/ indu/ry int]op]ability /&>ds4    
7#aa7 ,an analysis ( :e!r !             
int]op]ability ( ! ,oracle-,c]n] product
 ) ! private sector1 ! community c>e    
networks ( ! ,dep>tm5t1 academic        
hospitals1 ,f$]al heal? entities1 & o!r 
relevant heal? provid]s1 sy/ems1 &      
networks is demon/rably sup]ior to o!r  

electronic heal? records 9 ! heal?      
te*nology indu/ry4  7#ab7 ,a description
 ( :i* pa? or pa?s ! ,secret>y has      
select$ to take or n take1 ! reason =   
su* selection1 & ! key mile/ones to     
a*ieve any new c\rse ( action describ$1 
includ+ any new ,dep>tm5tal /ructures1  
e/imat$ life cycle co/s1 & timel9es4    
7#ac7 ,su* o!r matt]s z ! ,secret>y     
consid]s appropriate4  #djf4 ,report on 
lead]%ip1 acquisition1 & contract+      
ov]sight lessons le>n$  7a7 ,9 g5]al ,n 
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y1 ?r\gh 
! ,*ief ,acquisition ,(fic]1 ! ,"u      
,secret>y = ,heal?1 & ! ,executive      
,director ( ! ,electronic ,heal? ,record
 & ,heal? ,in=mation ,te*nology         
,mod]nization ,program ,managem5t       
,(fice1 %all submit to ! appropriate    
committees ( ,congress a report detail+ 
! /ructural controls1 programs1 &       
processes ! ,dep>tm5t has or w put 9 to 
place to prev5t curr5t or future        
failures ) respect to lead]%ip engagem5t

 & managem5t1 /rategic plann+1 contract+
 & contract ov]sight1 & program         
managem5t 9-- 7#a7 ! implem5tation ( !  
electronic heal? record mod]nization    
program ( ! ,dep>tm5t f #bjag to ! date 
( ! report2 &  7#b7 any l>ge            
acquisitions & major mod]nizations      
conduct$1 includ+ ^? t are ongo+ or     
plann$ by ! ,dep>tm5t aft] ! date ( !   
report4  7b7 ,elem5ts ,! report requir$ 
"u subsection 7a7 %all include--  7#a7  
/eps to improve ! composition ( &       
managem5t ( task ord]s plac$ on ! curr5t
 & any future electronic heal? record   
contract or o!r major acquisition or    
mod]nization1 includ+ cov]$ programs 7z 
def9$ 9 section #djc7;f772  7#b7 a      
timel9e to a*ieve ! re=ms describ$ 9 !  
report or ! date ^u :i* re=ms already   
put 9 place 7 f9aliz$ & implem5t$2  7#c7
 a description ( lessons le>n$ reg>d+ ! 
ne$ = /able consi/5t lead]%ip1 /rategy1 
& managem5t ( l>ge mod]nization programs
 & h[ to prev5t su* *all5ges z exp]i5c$ 
) ! electronic heal? record mod]nization

 initiat$ 9 #bjag f occurr+ aga9 9 any  
major program ( ! ,dep>tm5t2 &  7#d7 a  
description ( ! numb] ( act+ or         
,s5ate-confirm$ ,deputy ,secret>ies ( ! 
,dep>tm5t & ! numb] ( lead]s ( ! program
 managem5t (fice ( ! electronic heal?   
record mod]nization program ( !         
,dep>tm5t f #bjag to ! date ( ! report4 
7c7 ,legislative or adm9i/rative action 
,! report requir$ by subsection 7a7 %all
 include a description ( any legislative
 or adm9i/rative action necess>y to     
a*ieve ! /ructural controls describ$ 9  
su* subsection4  #djg4 ,report on       
contract sav+s1 s]vices provid$ at no   
co/ to ! ,dep>tm5t1 & contract co/      
incurr$ ) respect to ,oracle-,c]n]      
product ,n lat] ?an #ij days aft] ! date
 ( ! enactm5t ( ?is ,act1 ! ,deputy     
,secret>y %all submit to ! appropriate  
committees ( ,congress a report t       
conta9s ! foll[+3  7#a7 ,a detail$ li/ (
 ! s]vices1 functions1 or o!r matt]s t  
,oracle-,c]n] provid$ to ! ,dep>tm5t )\t
 comp5sation s9ce assum+ own]%ip ( ,c]n]

 9 ,june #bjbb4  7#b7 ,a li/ ( specific 
cr$its or reimbursem5ts1 to include     
doll> am\nts & an indication ( !        
specific failure = :i* ^? cr$its or     
reimbursem5ts are provid$1 ,c]n] or     
,oracle-,c]n] has provid$ to ! ,dep>tm5t
 across all doma9s = contract failure1  
s]vice-level agreem5t failure1 p]=mance 
failure1 tra9+ & *ange managem5t        
failure1 ticket sy/em failure1 & relat$ 
issues dur+ ! p]iod beg9n+ on ! aw>d ( !
 contract to ,c]n] on ,may #ag1 #bjah1 &
 end+ on ! date ( ! report4  7#c7 ,!    
e/imat$ & kn[n co/s1 bo? direct &       
indirect1 incurr$ by all facilities us+ 
! ,oracle-,c]n] product z ( ! date ( !  
report due to-- 7,a7 increas$ /aff+2    
7,b7 lo/ productivity2  7,c7 increas$   
ref]rals to community c>e2  7,d7        
copaym5t & debt managem5t actions2  7,e7
 /aff turnov]2  7,f7 r$uc$ collections2 
&  7,g7 o!r factors z det]m9$ by !      
,secret>y4  ,v ,coord9ation ) ,dep>tm5t 
( ,def5se  #eja4 ,qu>t]ly reports on    
sy/em uptime1 mod]nization1 &           

coord9ation activities = in=mation      
te*nology sy/ems & policies ( ,dep>tm5t 
( ,def5se affect+ op]ations ( ,dep>tm5t 
( ,vet]ans ,affairs  7a7 ,9 g5]al ,n    
lat] ?an #ij days aft] ! date ( !       
enactm5t ( ?is ,act1 & n less frequ5tly 
?an qu>t]ly !reaft]1 ! ,secret>y (      
,def5se %all submit to ! appropriate    
committees ( ,congress a report on !    
sy/em uptime1 mod]nization1 &           
coord9ation activities = in=mation      
te*nology sy/ems ( ! ,dep>tm5t ( ,def5se
 t are reli$ ^u by ! ,dep>tm5t (        
,vet]ans ,affairs to deliv] heal? c>e1  
comp5sation1 memorial b5efits1 & o!r    
s]vices requir$ to be provid$ "u ! laws 
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs4  7b7 ,elem5ts ,ea* report     
requir$ by subsection 7a7--  7#a7 %all  
id5tify /eps tak5 by ! ,secret>y (      
,def5se to improve gov]nance1           
coord9ation1 & policy decisions conduct$
 ) ! ,secret>y ( ,vet]ans ,affairs      
relat$ to in=mation te*nology ( !       
,dep>tm5t ( ,def5se & relat$ sy/ems ^u  

:i* ! ,dep>tm5t ( ,vet]ans ,affairs has 
an op]ational dep5d5cy2  7#b7 %all      
include a s*$ule = ! mod]nization or    
replacem5t ( key in=mation te*nology &  
relat$ sy/ems ( ! ,dep>tm5t ( ,def5se ^u
 :i* ! ,dep>tm5t ( ,vet]ans ,affairs has
 an op]ational dep5d5cy1 includ+ !      
,def5se ,enrollm5t ,eligibility ,report+
 ,sy/em1 or successor sy/em2  7#c7 %all 
include a s*$ule = ! movem5t by !       
,dep>tm5t ( ,def5se ( ! ,,mhs ,,g5esis  
s(tw>e & relat$ sy/ems to ! cl\d2  7#d7 
%all include in=mation reg>d+ goals = & 
actual uptime & /ability ( all in=mation
 te*nology & relat$ sy/ems ( ! ,dep>tm5t
 ( ,def5se--  7,a7 t ! ,dep>tm5t (      
,vet]ans ,affairs relies on to op]ate1  
manage1 or adm9i/] ! curr5t or any      
future electronic heal? record ( !      
,dep>tm5t ( ,vet]ans ,affairs2  7,b7 on 
:i* ! ,dep>tm5t ( ,vet]ans ,affairs has 
an op]ational dep5d5cy2 or  7,c7 t is a 
critical sy/em or s]vice reli$ ^u by !  
,dep>tm5t ( ,vet]ans ,affairs = !       
deliv]y ( heal? c>e1 comp5sation1       

memorial b5efits1 or o!r s]vices2  7#e7 
%all id5tify--  7,a7 any sy/em or       
sy/ems1 infra/ructure1 or relat$        
entities ( ! ,dep>tm5t ( ,def5se t are  
critical to op]ations ( ! ,dep>tm5t (   
,vet]ans ,affairs2  7,b7 any p]=mance   
issues ) respect to ^? sy/ems1          
infra/ructure1 or relat$ entities2  7,c7
 /eps tak5 by ! ,secret>y ( ,def5se to  
rem$iate any su* issues 9 ! %ort1 m$ium1
 & long t]m & timel9es = su* rem$iation2
  7,d7 ! acc\ntable (fices )9 !         
,dep>tm5t ( ,def5se = ! ma9t5ance1      
replacem5t1 & /ability ( ^? sy/ems1     
infra/ructure1 or relat$ entities2 &    
7,e7 policies & gov]nance /ructures     
reg>d+ collaboration & coord9ation ) !  
,dep>tm5t ( ,vet]ans ,affairs ) respect 
to *anges to ^? sy/ems1 infra/ructure1  
or relat$ entities2  7#f7 %all include a
 description ( ! def9itions1 monitor+1 &
 report+ ( s]vice level agreem5ts betwe5
 ! ,dep>tm5t ( ,def5se & ! ,dep>tm5t (  
,vet]ans ,affairs1 includ+ specific     
critical infra/ructure availability     

t>gets1 incid5t report+ mean "t to      
resolution1 & relat$ matt]s2  7#g7 %all 
include a description ( ! s]vice        
reliability measurem5ts 9 use & !       
previ\s qu>t]'s actual reliability data 
by ! ,dep>tm5t ( ,def5se z x relates to 
s]vices reli$ ^u by ! ,dep>tm5t (       
,vet]ans ,affairs measur$ z exp]i5c$ by 
! ,dep>tm5t ( ,vet]ans ,affairs1        
inclusive ( any ,dep>tm5t ( ,def5se     
network1 id5tity1 & security s]vices    
dep5d5cies2  7#h7 %all include a        
complete li/ ( incid5t report+1 root    
cause analyses1 aft] action report+1 &  
prev5tive measures = ea* ev5t 9 :i* a   
,dep>tm5t ( ,def5se sy/em or s]vice's   
degrad$ p]=mance or outage caus$        
op]ational h>m to ! ,dep>tm5t ( ,vet]ans
 ,affairs inclusive ( network & security
 s]vices degradations1 outages1 & relat$
 matt]s2 &  7#i7 may include an         
id5tification ( legislative or          
adm9i/rative action requir$ to accompli%
 ! goals 9 ! report4  7c7 ,initial      
report ,! fir/ report requir$ "u        

subsection 7a7 %all include basel9e     
in=mation1 includ+ curr5t sy/em uptime &
 goals & t>gets ) respect to sy/em      
uptime1 & /eps ! ,dep>tm5t ( ,def5se is 
tak+ to bett] meet /&>ds1 goals1 &      
t>gets ) respect to sy/em uptime4  7d7  
,subsequ5t reports ,ea* report aft] !   
fir/ report requir$ "u subsection 7a7   
%all1 = ! qu>t] cov]$ by ! report-- 7#a7
 discuss updates on ! in=mation provid$ 
9 previ\s reports1 includ+ sy/em uptime 
p]=mance2  7#b7 indicate ! p]=mance ( ! 
,dep>tm5t ( ,def5se 9 meet+ ! goals     
e/abli%$ 9 previ\s reports2  7#c7       
indicate ! /eps ! ,dep>tm5t ( ,def5se is
 tak+ to address ! areas 9 :i* !        
,dep>tm5t is n meet+ ^? goals2 &  7#d7  
indicate improvem5ts to & "w 9 progress 
t[>d /r5g!n+ policies & gov]nance       
/ructures reg>d+ collaboration &        
coord9ation ) ! ,dep>tm5t ( ,vet]ans    
,affairs ) respect to *anges to !       
sy/ems1 infra/ructure1 or relat$        
entities ) respect to :i* ! ,dep>tm5t ( 
,vet]ans ,affairs has an op]ational     

dep5d5cy4  7e7 ,t]m9ation ,?is section  
%all t]m9ate on ! date t is #aj ye>s    
aft] ! date ( ! enactm5t ( ?is ,act4    
7f7 ,appropriate committees ( ,congress 
def9$ ,9 ?is section1 ! t]m appropriate 
committees ( ,congress means-- 7#a7 !   
,committee on ,arm$ ,s]vices & !        
,committee on ,vet]ans' ,affairs ( !    
,s5ate2 &  7#b7 ! ,committee on ,arm$   
,s]vices & ! ,committee on ,vet]ans'    
,affairs ( ! ,h\se ( ,repres5tatives4   
#ejb4 ,coord9ation ) ,dep>tm5t ( ,def5se
 reg>d+ in=mation te*nology programs1   
sy/ems1 & s]vices  7a7 ,9 g5]al ,n lat] 
?an #de days aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,deputy ,secret>y %all      
submit to ! appropriate committees (    
,congress1 ! ,committee on ,arm$        
,s]vices ( ! ,s5ate1 & ! ,committee on  
,arm$ ,s]vices ( ! ,h\se (              
,repres5tatives a report indicat+ !     
additional support ne$$ by ! ,dep>tm5t f
 ! ,dep>tm5t ( ,def5se to make ! curr5t 
& future deliv]y ( heal?1 b5efits1      
memorial affairs & o!r s]vices ( !      

,dep>tm5t /able & successful1 includ+   
?r\gh reliable availability ( data &    
s]vices ( ! in=mation te*nology sy/ems &
 programs ( ! ,dep>tm5t ( ,def5se1      
includ+ ! legacy ,vist,a & new          
electronic heal? record ( ! ,dep>tm5t4  
7b7 ,elem5ts ,! report requir$ "u       
subsection 7a7 %all include a           
description ( support1 collaboration1 & 
coord9ation1 ne$$ by ! ,dep>tm5t f !    
,dep>tm5t ( ,def5se relat+ to-- 7#a7    
gov]nance betwe5 ! ,dep>tm5t ( ,def5se &
 ! ,dep>tm5t ( ,vet]ans ,affairs relat$ 
to in=mation te*nology1 sy/ems1 s]vices1
 networks1 & relat$ infra/ructure2  7#b7
 coord9ation & policy betwe5 ! ,dep>tm5t
 ( ,def5se & ! ,dep>tm5t ( ,vet]ans     
,affairs relat$ to in=mation te*nology1 
sy/ems1 s]vices1 networks1 & relat$     
infra/ructure2  7#c7 sy/em availability1
 /ability1 & uptime /&>ds ( critical    
in=mation te*nology sy/ems1 sy/ems1     
s]vices1 networks1 & relat$             
infra/ructure2  7#d7 def9ition1         
monitor+1 & report+ ( s]vice level      

agreem5ts betwe5 ! ,dep>tm5t ( ,def5se &
 ! ,dep>tm5t ( ,vet]ans ,affairs relat$ 
to in=mation te*nology1 sy/ems1 s]vices1
 networks1 & relat$ infra/ructure2  7#e7
 s]vice reliability measurem5ts z       
exp]i5c$ by ! ,dep>tm5t ( ,vet]ans      
,affairs1 includ+ any network1 id5tity1 
& security s]vice dep5d5cies ) !        
,dep>tm5t ( ,def5se2  7#f7 ! curr5t /ate
 & desir$ future /ate transp>5cy 9      
incid5t report+1 root cause1 aft] action
 report+1 & prev5tative measures =      
in=mation te*nology1 sy/ems1 s]vices1   
networks1 & relat$ infra/ructure ev5ts (
 ! ,dep>tm5t ( ,def5se 9 :i* ! ,dep>tm5t
 ( ,vet]ans ,affairs has an op]ational  
dep5d5cy2  7#g7 ! curr5t /ate & desir$  
future /ate ( network & security s]vices
 ( ! ,dep>tm5t ( ,def5se on :i* !       
,dep>tm5t ( ,vet]ans ,affairs has an    
op]ational dep5d5cy or t significantly  
impact ! ,dep>tm5t ( ,vet]ans ,affairs2 
7#h7 a description ( ! key sy/ems ( !   
,dep>tm5t ( ,def5se t ! ,dep>tm5t (     
,vet]ans ,affairs believes ne$          

mod]nization or replacem5t s z to       
improve deliv]y ( s]vices to vet]ans &  
op]ations ( ! ,dep>tm5t ( ,vet]ans      
,affairs2 &  7#i7 ,su* o!r relat$ matt]s
 z ! ,deputy ,secret>y may *oose to     
include4  ,,vi ,o!r matt]s  #fja4       
,report on legislative action requir$ ,n
 lat] ?an #ahj days aft] ! date ( !     
enactm5t ( ?is ,act1 & p]iodically      
!reaft] z ! ,secret>y consid]s          
appropriate1 ! ,secret>y %all submit to 
! appropriate committees ( ,congress a  
report reg>d+ any legislative action1   
includ+ res\rces1 requir$ to c>ry out   
?is ,act or implem5t a mod]niz$         
electronic heal? record & relat$ heal?  
in=mation te*nology sy/ems4  #fjb4      
,report on curr5t & future ,/ate        
int]op]ability ) legacy electronic heal?
 record1 new electronic heal? record1 & 
future pot5tial electronic heal? record 
& o!r heal? in=mation te*nology &       
ex*anges  7a7 ,report requir$ ,n lat]   
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,secret>y %all1 act+ ?r\gh 

! ,"u ,secret>y = ,heal?1 submit to !   
appropriate committees ( ,congress a    
report on ! curr5t /ate (               
int]op]ability1 includ+ ! level (       
int]op]ability1 ) ! ,dep>tm5t's legacy  
,vist,a electronic heal? record & legacy
 applications1 includ+ ! ,jo9t          
,longitud9al ,view]1 z well z ) !       
,oracle-,c]n] product 9 use at five     
facilities ( ! ,dep>tm5t betwe5 su*     
sy/ems1 applications1 & records & !     
,dep>tm5t ( ,def5se1 ! private sector1 !
 community c>e networks ( ! ,dep>tm5t1  
academic hospitals1 o!r ,f$]al heal?    
entities1 & o!r relevant non-,f$]al     
heal? provid]s & sy/ems4  7b7 ,cont5ts  
,! report submitt$ "u subsection 7a7    
%all include a description ( ! foll[+3  
7#a7 ,! level ( int]op]ability t exi/$  
be=e ! contract ) ,c]n] ent]$ into on   
,may #ag1 #bjah1 betwe5 ! ,dep>tm5t & ! 
,dep>tm5t ( ,def5se1 ! private sector1 !
 community c>e networks ( ! ,dep>tm5t1  
academic hospitals1 o!r ,f$]al heal?    
entities1 & o!r relevant non-,f$]al     

heal? provid]s & sy/ems1 includ+ /r5g?s 
& limitations1 & a description ( !      
applications & ex*anges 9 use by !      
,dep>tm5t to facilitate su*             
int]op]ability4  7#b7 ,! level (        
int]op]ability t exi/s z ( ! date ( !   
report betwe5 ! ,dep>tm5t & ! ,dep>tm5t 
( ,def5se1 ! private sector1 ! community
 c>e networks ( ! ,dep>tm5t1 academic   
hospitals1 o!r ,f$]al heal? entities1 & 
o!r relevant non-,f$]al heal? provid]s &
 sy/ems1 includ+ /r5g?s & limitations1 &
 a description ( ! applications &       
ex*anges 9 use by ! ,dep>tm5t to        
facilitate su* int]op]ability t are n ^?
 procur$ z "p ( ! contract ) ,c]n] ent]$
 into on ,may #ag1 #bjah4  7#c7 ,! level
 ( int]op]ability t exi/s z ( ! date ( !
 report betwe5 ! ,dep>tm5t & ! ,dep>tm5t
 ( ,def5se1 ! private sector1 !         
community c>e networks ( ! ,dep>tm5t1   
academic hospitals1 o!r ,f$]al heal?    
entities1 & o!r relevant non-,f$]al     
heal? provid]s & sy/ems1 includ+ /r5g?s 
& limitations1 & a description ( !      

applications & ex*anges 9 use by !      
,dep>tm5t to facilitate su*             
int]op]ability t are solely ^? procur$ z
 "p ( ! contract ) ,c]n] ent]$ into on  
,may #ag1 #bjah1 & t are 9 use at ea*   
facility ( ! ,dep>tm5t 7includ+ any     
subsidi>y facilities1 su* z             
community-bas$ outpati5t cl9ics7 t is   
us+ ! ,oracle-,c]n] product "u su*      
program z ( ! date ( ! report4  7#d7 ,a 
discussion ( ! limitation ( !           
,dep>tm5t's int]op]ability ) :om & ( :at
 nature1 if any1 describ$ 9 p>agraphs   
7#b7 & 7#c7 & h[ ! ,secret>y =esees su* 
limitations be+ resolv$ 9 :ole1 9 "p1 or
 9 no way ?r\gh a cont9u$ deploym5t ( ! 
,oracle-,c]n] product1 a procurem5t (   
ano!r electronic heal? record1 o!r heal?
 in=mation ex*anges1 networks1          
applications or solutions4  7#e7 ,a     
compreh5sive int]op]ability roadmap &   
/rategy = ! next five fiscal ye>s1      
includ+ goals1 int]op]ability levels1   
p>tn]s1 timel9es1 regulatory & legal    
limitations & *all5ges1 & requir$       

res\rces & au?orities to a*ieve su*     
goals4  7#f7 ,a description ( ! role    
int]op]able data ex*ange plays 9 improv+
 heal? c>e outcomes & c>e coord9ation = 
vet]ans :o are eligible to receive heal?
 c>e ?r\gh programs & s]vices ( !       
,dep>tm5t & :e!r int]op]ability alone   
improves heal? c>e outcomes1 access1 &  
quality or :e!r x mu/ be "p ( a l>g]    
function+ electronic heal? record t c   
facilitate1 among o!r actions1 ! deliv]y
 ( physician ord]s1 ref]rals1 disp5se   
prescriptions1 s*$ule appo9tm5ts1 & o!r 
su* f\ndational & r\t9e elem5ts ( mod]n 
heal? c>e deliv]y4  7#g7 ,o!r su* matt]s
 z ! ,secret>y consid]s appropriate1    
includ+ recomm5dations = legislative    
action to a*ieve ! goals set =? 9 !     
report4  7c7 ,discussion ,! discussion  
includ$ "u subsection 7b77#d7 %all      
include ! foll[+3 7#a7 ,a cle>          
indication ( :at entities ! ,dep>tm5t   
exp]i5ces ! greate/ level (             
int]op]ability limitations 9 curr5t /ate
 su* z ! ,dep>tm5t ( ,def5se1 community 

c>e networks ( ! ,dep>tm5t1 academic    
hospitals & ! ,dep>tm5t's solution or   
solutions = rem$y+ ^? limitations4  7#b7
 ,a description ( :at curr5t heal? c>e  
ref]ral patt]ns1 pati5t volumes1 &      
networks x curr5tly exp]i5ces ! greate/ 
volume ( c>e ref]ral1 data ex*ange &    
int]op]ability transactions & h[ su*    
patt]ns & volumes are project$ to evolve
 & *ange ov] ! next "o1 five1 & t5      
fiscal ye>s4  7#c7 ,9 provid+ !         
description requir$ by p>agraph 7#b71 an
 indication ( :e!r ! volume ( c>e       
coord9ation1 record ex*ange1 & relat$   
matt]s is expect$ to be great] ) !      
,dep>tm5t ( ,def5se 9 ! next "o1 five1 &
 t5 fiscal ye>s or ) community c>e      
networks ( ! ,dep>tm5t1 academic        
hospitals1 & o!r ,f$]al & non-,f$]al    
heal? entities4