[T]he Green Mountain Care Board has signed off on a slimmed-down, $5.9 million budget for the state’s troubled health information exchange.
Care board members on Wednesday gave unanimous approval to the proposed fiscal 2019 budget for Vermont Information Technology Leaders, also known as VITL.
In doing so, the board further endorsed a multifaceted plan to resolve persistent problems with the state’s online patient-record database.
“A problem was recognized, and folks have come together to solve this problem over the next two years,” care board member Tom Pelham said. “I’m hopeful that those in the field that use and depend on VITL will be much happier customers.”
Burlington-based VITL operates a secure database of patient records such as lab results, discharge summaries and medication histories. The idea is that a physician can access that data no matter where a patient is being treated, thus making health care safer and more efficient.
But VITL has been plagued for years by administrative and financial problems. That came to a head last year when a consultant’s report said there were relatively few patient records in the system and most users had “lost confidence” in the exchange.
Since then, both VITL and the Department of Vermont Health Access have been working to improve the system, which has received more than $40 million in state and federal funding. That improvement plan is partially outlined in H.901, which Gov. Phil Scott signed into law this week.
The statute calls for the state and VITL to submit a detailed work plan, which already is complete. Later this year, a contingency plan will outline how the state can find a new exchange operator if VITL can’t meet its goals.
Also later this year, the Department of Vermont Health Access is required to submit a new, statewide health information technology plan for the care board’s approval. Michael Costa, the department’s deputy commissioner, has said the report will answer two questions: “What do we want, and can VITL deliver it?”
Susan Barrett, the care board’s executive director, on Wednesday said H.901 is “an excellent bill, and I think a good guidance document for us, and for (the department) and VITL.”
As the Legislature worked on the problem over the past several months, VITL also was making changes. The organization has hired new leadership; has been boosting the number of patient records in its system; and submitted a fiscal 2019 budget that decreases VITL’s reliance on state funding by $500,000.
The organization’s reduced spending is due mostly to personnel reductions: VITL now has eight fewer full-time positions than it had in fiscal 2016. Mike Smith, the new president and chief executive officer, has said VITL is “transitioning to a leaner and more focused organization.”
Green Mountain Care Board staff members on Wednesday recommended that the board approve VITL’s proposed budget. They also lauded VITL’s cooperation and transparency, echoing praise that’s been expressed by Costa.
The care board did not receive any public comments on VITL’s proposed budget and approved it with little discussion. There is one condition: VITL and the Department of Vermont Health Access must return to the board later this year to present their spending plan for the second half of the fiscal year, because VITL currently is operating on a six-month contract with the department.
Much work remains to get VITL back on track. And the stakes are high: The final version of H.901 says that, if VITL can’t meet the Legislature’s goals, “it is the intent of the General Assembly to eliminate the designation of Vermont Information Technology Leaders, Inc. to operate the exclusive statewide health information exchange network for Vermont.”
But Pelham lauded care board staff, state officials and VITL leaders for their work so far, as well as the consultant that issued last year’s critical report on the health information network.
“This last year has been a tremendous year of change,” Pelham said.
