Decision Package
Electronic Health Record System
AgencyDepartment of Health (601)
Budget RoundInitial Bill
Bill VersionRegular Session
CategoryInformation technology
DPB InitiatedNo
Exclude from Bud DocNo
Source of RequestAgency
RegionMultiple Regions
Approp. Act Language Required?No
Legislation Required?No
Enterprise StrategyEmbrace innovative models of care and new technologies to improve health outcomes and lower costs.
Last Saved9/17/201911:00 AM
Agency Description
The Virginia Department of Health (VDH) is requesting funding to procure a fully functional Electronic Health Record (EHR) data system that is certified to all industry standards, meets federal requirements, and is capable of intraoperatively interfacing with EHRs used by other agencies within the Commonwealth which serve many of the same clients as well as non-state supported state information technology systems that house critical health and public health information. The EHR system must have the capacity to provide robust scheduling, capture assessment, diagnosis, progress notes, and document medical information including electronic prescribing and laboratory results. The system must also have functionality for assessing fees, generating automatic billing, offer Accounts Receivable (AR) management tools and reports, and generate quality review reports. The system must account for the delivery of a complex array of public health services offered by local health departments across the Commonwealth.
Consequences of not funding/Justification
VDH currently lacks an integrated EHR system. Medical follow-up and care is still provided for the overwhelming majority of service lines using paper records which leads to operational inefficiencies as well as potential duplication of efforts leading to increased costs for clients and the Commonwealth. Current users must access other health systems using multiple interfaces, and medical records for patients who have sought care with other providers are faxed or mailed to local health departments, imposing significant time and costs for the handling, sorting, and incorporation of pertinent information into each individual’s medical history. Service delivery for residents of the Commonwealth can also be drastically improved by offering a patient centric system that also offers access to patient self-data via patient portals.

Without the increased general fund support, VDH will continue to falter behind the standard level of healthcare infrastructure. The agency will lack the ability to efficiently provide patient level data access and will not be able to share key data elements with the other Health and Human Service Agencies or other health care facilities and entities to ensure optimal care of patients. This would result in a continuation of lost patient care opportunities for the residents of the Commonwealth, particularly for patients that rely on VDH and the other Commonwealth agencies as their safety net provider.

The VDH two-year total request (Years 1 & 2 of a 7 year project) is based on an estimate provided by a contractor to the agency which comprises mainly of the cost for work performed by the contractor but also allows VDH to hire 2 FTEs to perform in-house business analysis and project management. Depending on the solution that is ultimately determined for the department, VDH projects additional costs to allow for customization of services to meet a public health model for delivery of services (allowing for encounters solely requiring a health educator or nurse visit rather than a practitioner, meeting medical and clinical requirements of education and counseling as required by federal grants, etc.) versus EHR solutions that currently exist that are intended for a more traditional outpatient experience or are geared towards hospital-centric service lines.
Alternatives considered (must list at least one)
The alternative considered is to continue with the current mode of medical service delivery and patient data capture which is paper-based, leading to inefficiencies in care, delays in transfer of patient information, and potentially result in unnecessary delay of a treatment plan or follow-up for a patient. Patients would not be able to benefit from real-time electronic access to medical records, care provided by Commonwealth agencies to the same patients cannot be as well integrated, and cost savings from unnecessary duplication of services by having access to a patient previous and most recent medical and laboratory results cannot be achieved. While certain components of the patient experience (mainly the finance, accounting and billing) currently use an electronic system, VDH staff will have to continue to utilize multiple systems and interfaces for each patient in the delivery of overall care and will be unable to benefit from more recent and comprehensive report generating modules of more current information technology solutions.
Explanations and Methodologies
The cost estimates come from a report prepared by a consultant after meeting with key VDH leadership and subject matter experts. The consultant then created an estimate of cost over a 7-year cycle roll out. In addition to the consultant's cost, VDH determined the need for initial staffing (project manager and business analysis -FTE & Cost) to support early project development. VDH cost increases as the consultant's cost decreases to cover ongoing customizations and business practice changes that VDH would need to embrace and engineer to ensure successful implementation.
Object TypeFY 2021 ReqFY 2022 ReqFY 2023 ReqFY 2024 ReqFY 2025 ReqFY 2026 Req
General Fund Dollars$7,011,531$8,320,216$9,769,400$3,666,660$3,666,660$3,666,660
Nongeneral Fund Dollars$0$0$0$0$0$0
General Fund Positions2.
Nongeneral Fund Positions0.
General Fund Transfers$0$0$0$0$0$0
General Fund Revenue$0$0$0$0$0$0
Additions to Balance$0$0$0$0$0$0
More Details
Program CodeProgram NameFY 2021 ReqFY 2022 Req
440Community Health Services$7,011,531$8,320,216
Fund CodeFund NameFY 2021 ReqFY 2022 Req
01000General Fund$7,011,531$8,320,216
More Details
Program CodeProgram NameFY 2021 ReqFY 2022 Req
440Community Health Services2.002.00
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