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House Veterans' Affairs Subcommittee presses VA on gaps in health‑record interoperability with community providers
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Summary
Witnesses and lawmakers at a House Veterans' Affairs Subcommittee hearing said progress has been made on health‑information exchange but identified persistent connectivity, data quality and staffing gaps that leave community care records incomplete for many Veterans.
Chairman Barrett opened a House Veterans' Affairs Subcommittee hearing on interoperability by saying the Department of Veterans Affairs must ensure veterans' health records "move with the veteran regardless of which EHR is being used" and urged VA to provide written testimony ahead of hearings. The panel heard testimony from VA officials and health‑information‑exchange and provider representatives about technical progress, persistent data gaps and workforce and contract pressures that the witnesses said limit full, reliable sharing between VA and community clinicians.
Why this matters: Veterans receive care both inside VA facilities and from community providers; roughly one‑third of VA care is delivered in the community, panelists said. Incomplete or hard‑to‑use records can delay diagnosis and duplicate testing, hampering clinicians' ability to deliver timely care, committee members said.
VA officials described recent work and concrete metrics. Dr. Jonathan Nebeker, VA's Chief Medical Information Informatics Officer, said Joint Longitudinal Viewer (JLV) users — more than 110,000 VA employees in January 2025 — opened about 2,200,000 community care documents that month. The Joint Health Information Exchange (JHE) connected to national exchanges and, Nebeker said, exchanged roughly 36,000,000 documents for about 18,000,000 patient matches in January 2025. Nebeker said VA aims to be participating and tested for TEFCA (the Trusted Exchange Framework and Common Agreement) and a qualified health‑information network (QHIN) contract by early December 2025.
State and provider witnesses described how regional health information exchanges and hospital systems operate day‑to‑day. Rick McGraw, chief growth officer at the Michigan Health Information Network (MiHIN), said MiHIN routes messages from 5,300+ facilities, routes more than 8.3 billion messages historically and delivers admission/discharge/transfer summaries to participants in under four minutes. Dr. Andrew Rosenberg of Michigan Medicine and Dr. Leo Greenstone (Signature Performance) said modern EHRs and exchanges have transformed data flows, but providers still often rely on fax and manual uploads when connectivity or data quality is lacking.
Persistent gaps and causes: Witnesses and lawmakers identified three recurring problems.
- Connectivity gaps: Nebeker and witnesses said VA is connected to large national exchanges and estimates being connected to roughly "90% of hospitals" but that many smaller hospitals and far fewer individual physician offices are not exchanging data with VA. Nebeker said about 30% of providers billing VA for community care are connected to the national exchanges he cited.
- Data quality and format: Witnesses described inconsistent content in exchanged records — missing office notes, procedure reports or discrete lab values — and clinical systems that export documents in ways that are unreadable or incomplete for receiving systems. Nebeker gave examples including incorrect weights, missing serum sodium values and misclassified allergies. Participants said data quality problems reduce the clinical usefulness of records and complicate automated decision support and population health work.
- People, contracts and resources: Ranking Member Budzinski and other members pressed VA about recent personnel actions and contract pauses. Committee members said reduced scanning and health‑information‑management (HIM) staffing can create backlogs of records that then never make it into searchable, structured fields. VA witnesses said they would provide the committee follow‑up information about staffing impacts and contract changes.
Committee requests and next steps: Members repeatedly asked VA for follow‑up data on (1) the number and roles of VA staff affected by recent personnel actions, (2) cancelled or paused contracts that support EHR modernization and interoperability, and (3) the contractual requirements and timeliness for community providers to return records to VA after a community encounter. Nebeker and other VA witnesses said they would take those questions back and provide responses to the committee.
No formal votes were taken during the hearing. Lawmakers emphasized oversight and requested written follow‑up materials be entered into the record.
What participants recommended: Witnesses urged VA to complete planned TEFCA/QHIN participation, to work with regional health information organizations (RHEs) and HIEs such as MiHIN to close local gaps, and to include data‑quality provisions and incentives in payer and provider contracts. Witnesses and members underscored that technology alone is not sufficient: consistent workflows, training and sufficient HIM staffing are necessary to ensure records are captured and integrated into VA systems.
The hearing record will include submitted written statements from VA, MiHIN, Michigan Medicine and Signature Performance. Committee members said they will use the testimony and follow‑up responses to continue oversight of VA's interoperability implementation.
