And outside of washington. With that id like to bring up secretary again to talk with all of you about the big announcement he made this morning about historic modernization of the va medical record system and as a reminder, as always, i would encourage you to please be respectful and keep your questions on the topic at hand and i will be happy to answer questions on other topics after words. Thank you, sarah. Im glad to be here today. As sarah said earlier today, i made the announcement about the department of veteran Affairs Decision on the Electronic Health records. Normally, that is not too exciting decision about a product but i have to tell you im very excited about this. I think this will make a big difference for veterans everywhere and it will make a big difference for the department of veteran affairs. I want to say from the outside that when the president selected me to be secretary, he made clear to me that he expected us to act with faster decisions, act like a business and to really make sure that we are doing the right thing to change veterans healthcare. Thats exactly what were trying to do today. I had told you when i was here last week that i would make a decision by july 1st and i want to let you know that were coming back earlier and that im honoring that commitment. Having an Electronic Health record that can follow a veteran during the course of his health and treatment, is one of the most important things, i believe, you can do to ensure the safety and the health and wellbeing of a veteran. So, thats why this is so important. I told congress recently that i was committed that the va would get out of the Software Development business and that i did not see a compelling reason why being in the Software Development this was good for veterans and because of that i made the decision to move away from our internal product to an offtheshelf commercial product. As you may know, almost all of our veterans get to us from one place and thats the department of defense. When i went back and looked at this issue very carefully since becoming secretary, i was able to trace back at least 17 years of congressional calls and Commission Reports requesting that the va not only modernize the system but worked closely with the department of defense. So, that went back to 2000. Actually to this day, the department of defense is saying that the department of Veterans Affairs have gone in several ways. We each have separate systems and each are supporting separate Electronic Systems and while we been able to advance and drop at the cost of hundreds of millions of dollars to the taxpayers, today, we still have separate systems that do not allow for the seamless transfer of information. I just want to expand on that a little bit being a doctor. What we are able to do at the department of defense over years and years and, as i said hundreds of millions of dollars, were able to read each records now. Thats called interoperability. What you are not able to do is actually Work Together to plan a treatment to go back and forth between the department of defense and va. Weve not been able to obtain that to this point. So, for those reasons i decided that va will adopt the same Electronic Health record as the department of defense so, we will now have a single system. That system is known as the mhs genesis system which, at its core, is millennium. The adoption of the same system between va and dod is going to allow all patient data to reside in a common system so you will have the seamless link in the Department Without the manual or Electronic Exchange of information. So, a secretary, i think, im not willing to put this decision off any longer. Seventeen years and spend too long. When dod went through its decision on Electronic Medical records and its acquisition process in 2014, it took them approximately 26 months to do this and i will tell you, in government terms, thats actually a pretty efficient process. I dont think we can wait that long when it comes to the health of our veterans. So, under my authority as secretary of va, i am acting to essentially do a direct acquisition of va currently being employed by the department of defense that will be across the entire va enterprise thats going to allow the Seamless Health care for veterans and the qualified beneficiaries. Once again, because of the health of our veterans, i have decided that we are going to go directly into the dod process for the next generation Electronic Health records. Let me just tell you, this is the start of the process. Va has unique needs that are different than the department of defense and for that reason ba, while adopting an identically charged dod, we need additional capabilities to maximize interoperability with our community providers. You know, one third of our healthcare goes outside the va into the community and that is critical that we can have the same interoperability with our community providers. We are going to have our va clinicians very involved in how we develop the system and how we implemented because in many ways the department of Veterans Affairs is actually well ahead of the department of defense and clinical it innovations. We are not going to discard all of the things that we have done in the past and, in fact, we are going to help dod get better. This is a system that will strengthen care for veterans and are active servicemembers. We are going to be embarking upon something that has never been done before that is an integrated product, using the dod platform that is going to require this integration with other vendors to create a system for veterans so that they can get care both in the community as well as the department of defense. That will take the active cooperation of Many Companies and thought leaders and it will serve as a model, not only for the federal government, federal agencies working together for all of healthcare that is trying to seek this type of interoperability. Once again, i want to think the president for his incredible commitment to helping our veterans and support the va. I also want to thank the department of defense who have been incredibly helpful in this process and the American Office of innovation that has been incredibly helpful in helping us think differently about how to solve problems. This mission is too important for us not to get right. I assure you, we will. Ill be glad to take any questions. One, how long will this take . He said at the beginning process. To how will veterans know and feel and experience a difference because of this decision . Great question. This is the beginning of the process and we will start essentially entering into the details of how we would implement a contract. We expect that process, again, trying to do it as quickly as possible but it will be about threesix months, at the latest. During that time we will be developing both the Implementation Plan and the cost of the system so that we can go out and make sure that were doing this right and that we have the Resources Available to do it. Secondly, to a veteran they are now going to be able to have a single system from the time that they enlist in the military until, potentially, they die. One single lifetime record. There will never be a need to be able to go back and forth and say records arent there for me or my doctor isnt able to have input into what the department of defense is doing and our Community Partners need that same type of interoperability. How will that change things for people in the system now . Mike, our top clinical priority is to help veterans with suicide. Weve identified a gap in their transition when you leave the military and you know have that shock structure that you are used to and what happens to you before you get enrolled into either va healthcare or Community Health care that no longer is going to happen. We will have a seamless ability to make sure that information is there. So, to a veteran was experiencing emotional disorders, when they reach out for help it will be easier to get them help. For other people who have physical problems, that same information will be there to develop a coordinated care plan. Secretary, youre having Competitive Bidding for this perspective a ballpark estimate . Is a factor into your current budget . We are not started the cost negotiation. We know they had a 4. 3 bigger contract and the va is a bigger. Part of the reason why i have way that process is i absolutely believe and i spent a lot of time in reviewing the materials it is in the Public Interest to move quickly and i also believe we can do this cheaper for the taxpayers by, essentially moving forward quickly without a lengthy process. Yes, sir. Secretary, you are part of the last administration you were deputy va secretary and is there a particular reason why this process with your announcing today did not take place for the oman Obama Administration did you drop the ball in the obama ministration contract could you explain a little bit. This is one of those problems i talked about last week with all of you. I think its manned the administration has been going on for decades. I can count no fewer than seven blueribbon commissions that have recommended that we move in a direction like this, the commission on care which was a 68 million study came out with this recommendation and so, people have felt that this was a direction that they should be moving in and i will tell you that it is hard to make decisions. Theres a lot of built in movement to keep things the way they are. So, while in the last administration we considered this, and we looked at a number of things, i think, it really was this administration and the president needs to do business differently that allowed us to move forward with this type of speech and speed. Yes, sir. At what point number one. When does the veteran actually began to experience this . That is what were going to be determining for the timeline during this pre sixmonth. When we roll out. I do believe, and everything im doing, is trying to act the speed that working with the department of defense and already using the penny materials and their team and management tools we will be able to do this much faster than if we had done it alone. The department of defense has already taken a period of time for they implemented their first system and fairchild airport base which has been successful. We will be able to do arent even faster than they did. Thanks again to secretary matters and the department of defense. They have, actually, detailed over to us some of their Key Executives who have worked on their projects and they now are at va and there helping us actually begin this. We had Institutional Knowledge from them thats considerable. Your second question had to do with who at the white house has been working with us. I will tell you that in this decision i not only reviewed large numbers of reports, independent, managements of that we had consultants help us with but i consulted with all the stakeholders that i could. Hospital cios and ceos, members of congress and people at the white house to be able to talk to all the stakeholders to make this decision. At the white house, of course, we talk to the president s office but also working closely with the American Office of innovation. All those are stakeholders that contributed to my thinking. Yes. During the bush years when it came to medicaid and medicaid and the obamacare we knew [inaudible] no guarantees. Highrisk process especially when youre doing in this and the largest integrated Health System in the country. This is highrisk. Its one of the reasons why i made this decision. By going with the department of Defense System we are lowering our risk because we have a federal partner is already gone through this process and thats why were taking their expertise and putting it into ba. Again, with secretary matters to work with us closely we are lowering the risk. As a privatesector ceo, ive done this several times successfully but ive never done it on this scale so, the risks are there but we will make sure that we do this the right way. What happened to those older veterans who have problems youre doing this now and trying to integrate now but happens to those who have been in the system for a long time . Where do they come in and how long will this take to help them . This is a problem that many healthcare that have transitioned to other Electronic Healthcares have found that you do not discard your old information. That would be clinically youre irresponsible. You have to have a way to make sure that the old information is they are and transitions into a new system or remains available for clinicians to have. Thats a problem that will be pretty good at handling. Yes, sir. Can you share that with a specific. Management consultants have looked at this issue offtheshelf first stain with maintenance and theyve helped us look at the cost benefit decision. That was part of my thinking and this is essentially the most costeffective way to go to a commercial offtheshelf system. The problem with what va has been doing is we have a 4. 100 billion budget in it and 70 is maintaining our current systems. Our systems are getting older, the bandaids are getting older and harder to hold the system together and each year i believe will get more and more expensive to modernize our own system and we are unable to keep the type of people we want. The best cost benefit decision for taxpayers and for veterans is to move to an offtheshelf system back followup to. Youre talking about an offtheshelf system christmas youre not developing new system benchmark the biggest problem is security. One of the reasons again why i chose to go this route is because of the Cyber Security. The department of defense has already invested in such high Cyber Security standards that those are the standards that we need to be able to assure privacy and security for our veterans. Thats part of the reason why we are doing this. Just to be clear, we are adopting an offtheshelf system but, as i mentioned before, we are also embarking upon something no one has done before because it is these commercial systems dont talk together and we need them to talk together because many of our patients are out in the community and our academic partners, many of them, use other systems beside cerner. We are creating something that is taking the best of whats offtheshelf but creating something that doesnt exist today. Yes. [inaudible] i would love to do it for less but that would be unrealistic. You dont have a ballpark . Yes. [inaudible] weve already begun to engage, starting today, with the appropriations leadership in both senate and house. I will tell you that this is something that congress has been asking for, i believe they will support this. Of course, this has to be a dialogue between us. They have to make sure that we are making the decision at the benefit of the taxpayers as well as veterans and active servicemembers but, i do believe, we will have the leadership and partnership to get us there. If this is an offtheshelf system this is not a you are not putting this out to bed . We have not agreed upon any pricing. I can assure you that before we were to sign off on a contract we are going to make sure that this is the best value for taxpayers. Yes. What kind of fight do you expect from congress when youre not having a competitive bid . This would be washington if there wasnt pushback but i dont expect, i do not expect, any major fights on this. I think the one thing that i feel extremely proud about about the way that congress has acted when it comes to Veterans Issues is the bipartisan support when its the right thing to do for this countrys veterans. I do expect that to essentially carry through on this. That does not mean that it is not appropriate to ask hard questions, to make sure the Due Diligence is they are, to make sure as we said this is a risky process and that we thought about everything and that weve considered people who have different options but in the end, i do believe, this is something that we will see strong bipartisan support for. Is this another version of one of my colleagues question. Dhr has been promised for, why is it going to happen if it was promised during the Previous Administration and why would it happen now is what we havent seen evidence of bipartisan support so what makes you hopeful at this time . Im not seen the department of veteran affairs come out with this type of decision before. So, this is new. We now know what is in the best interest of veterans and we are moving ahead with an accelerated process so we can get this done. I do believe that this exactly what congress has asked us to do. I can count four times with a vast dod nda to get in the same room and i can count for times when va and dod left doing separate things. This one will be different. The department of defense and the department of veteran affairs are to gather in step with this and passes behind us but we need congress to support it and i believe that support will be there. Yes, all the way in the back. [inaudible] we are doing exactly that. We are in discussions with the department of defense, secretary matus and i have talked about this. We know that what we are doing is not enough and we have to look exactly the issues that start in the department of defense and make sure that we are addressing them, the transition time and that gap between when you leave active service to when you enter a civilian and you get healthcare. That is an area that we have to pay particular concern to and thats why this will be helpful. We have to look all the way back into the process just as you are suggesting. We are doing that. Yes, sir. You mentioned seven commissions this request on the opposition in the past . I think one of the things that we are doing differently in this administration is that we are essentially eliminating some of the silos in turf battles. Frankly, i think that if you put the veterans and the servicemember first, you would come to the conclusion that weve come to today. But nobody likes to give up power and control over their system. In the department of Veterans Affairs we are very, very proud of our history of being the first major system to develop Electronic Medical records. This is done over 30 years ago by brave clinicians who went on their own and develop this. Giving this up, i do not want to underestimate how difficult that will be for people in the department of Veterans Affairs. Change is not easy but when you have that for 30 years it will be hard. This is a major decision for the department of Veterans Affairs. As ive said previously, i wish that the department of defense had joined us years and years ago so that we could be working together but that isnt the situation i face as secretary. Dave move forward and its time that we move forward and come together. Ill take one more question. [inaudible] when i became secretary and the office was that up, they indicated a strong interest in helping the department of Veterans Affairs which i welcomes. When we sat down and they said talk about the main points, what you really need to do to make a quantum leap in where you are. I identified the electronic records. What we talked about is best practices about how industries make quantum changes, how you go out and solicit information from leaders in the field to make sure that you get the right stakeholders in opinions. They were advisory in this process. This decision, though, with my decision fully to make. There was no influence ever put on this but they were very helpful in helping this and move the progress along. And in facilitating discussions with the department of defense, as well. Thank you very much, everyone. I appreciate it. Thank you very much, mr. Secretary. As Vice President noted this morning the American People elected a builder to be the 45th president of the united states. A builder who has a vision to modernize in the entire federal government. The secretary talked about this vision is carried out at the va. This morning the president launched a great new era in american aviation starting with the modernization of our outdated air Traffic Control system. Today, everything from the cars on the road to the cell phones in our pockets use gps technology. Washington has been unable to upgrade the air Traffic Control system from groundbased radio and radar system despite 14 years of attempts by the faa. This delay has left a stock with a system that just cant keep up with an industry that has grown exponentially since it was designed. Our current air Traffic Control system cost our economy as much as 25 billion a year and delays, inefficiency and unreliability. This is a problem that nearly everyone agrees it needs to be solved. Joining the president today with representatives from the air Traffic Control unit, passenger advocates, leaders of airline and Cargo Companies and every former coo of faa. Those arent groups that typically agree on much of anything but even with all of these stakeholders behind air Traffic Control reform it was still stuck in the washington political machine. President elected to unstick these kind of comments efforts and will be continuing to work with congress on getting these principles turned into legislation and getting that legislation to the president s desk. The company the president s announcement the department of transportation today launched a new micro site as martyrs guys. Com which will continually be updated with fact sheets, q and a and other information regarding the reform. Infrastructure is only one of the many actions items on the president legislative agenda and to help we are Engaging Congress on the American Congress acts which we hope will take up soon. On the legislative agenda and including repeal and replace obamacare to craft a revolutionary tax form proposal to provide relief to our working taxpayers performance day infrastructure week continues with a visit to Cincinnati Ohio he will speak about his wideranging vision for rebuilding the country with a special focus on the 12,000mile inland waterway system carried 230 billion of commerce annually to present to the sustainable solution will be presented on wednesday to ohio preworld deeply concerned about each of my children to carry on with tradition george will be to on thursday so happy early birthday and with that i will take your questions. Also on wednesday director comey is scheduled to testify and there are questions of though white house will allow him to testify. He is scheduled to testify on thursday will you vote executive privilege allowed to testify . In order to facilitate a swift and thorough examination of the facts with the Senate Intelligence Committee President trump will not desert assert executive privilege. With the solicitor general to make arguments before the supreme court. The president is very focused on exactly what that order spells out to protect americans, protect National Security so they maintain that and that has not changed in the slightest. Why isnt the is the president picking a fight with the mayor of london right after the terrorist attacks . Finigan all the key he is picking a fight at all but the point is that frankly it has been almost two years with the president talked about how we have to be more committed to National Security one of the reasons that is the point is trying to make. That is not what the mayor has said in fact, that the threat level remains of the year to say dont be alarmed with the Police Presence on the street to be directly misrepresented. Title think that is true. Police said there is no reason to be alarmed by an attack on the city . But there is a reason we have constant attacks going space across the globe and we have to start putting National Security and Global Security at an alltime high president has been very clear in he is not backing away from that. What was the president s reaction . The president is committed to continuing to have conversations with all people involved in the process we want to continue to day escalate with each of those partners. Did they know that this would happen . I am not aware of that but the state department would be better able to answer the question. The president we did earlier today treated earlier today about the travel ban earlier in the administration trying to adjust by the executive order with travel restrictions the white house is adamant it was not a travel ban is it . Of think the president cares what you call it weather a be an order a restriction he cares that we call a National Security it is simple everybody wants to get into the labels but the bottom line is he tries to protect the citizens of this country it is extremely clear the lot is extremely clear and the president s priority protecting the people is very clear. There will be folks about the of president hacking the mayor of london . Not all and to suggest that is ridiculous. Given the importance of twitter in the communication strategy is that vetted by a of a lawyer or any other aid . Not that i am aware of but social media is important it will give them the ability to the people without the bias of the media so at this point with over 100 000000000 contacts through social media and all platforms it is an important program. I have a question with the comments the president made this morning said to be with the original executive order, if you wanted to stick with the original why did he order the department of justice to stick with that . They were trying to meet the demands but the president has been very clear under the constitution to protect the people in this country and that was another version of that that be clear these are six countries not just by this administration but by a obama and congress that are not stable and frankly not capable or even unwilling thats what this is about everybody wants to make it Something Different in National Security that is why they are focused on pushing everybody for word. So why did he sign the second one . So to match the demands laid out by the ninth circuit with that expediency as the best way possible to move the process for word. It may not be politically correct. Again he supports moving in the direction once a strong guest executive order out there and that is the reason for that. The original intent was to review immigration policy it has been nearly five months. Extreme the betting is taking place and that was laid out in the memo. But specifically though . If you want to get down into the details i will refer you to the department of justice but there are over 300 people under investigation that are part of the process for terrorist related activities that is a large part of the vetting process. Is essentially we did not get around the filter of the biased media just this morning so does that matter matter . It think matters in the sense of the tool that is unfiltered through media bias but through every period was a perfect example to make a mistake the colleague politely corrected him as somebody from our administration would have done the same all hell would have broken loose it is total chaos and conundrum here at the white house. Especially over every detail of. That comes directly from the president. To fall upon the travel ban. [inaudible] he has he has asked for the expedited process. Why dont we have one yet . Is there a reason for the delay . I am not sure. In addition to the expedited process that so we can see a tougher version is the third version in the works . Not that i am aware of the president will continue to take aggressive steps every day to protect people in this country. But is there a tougher version . We are trying to protect the American People and that is part of the process but i dont know specifically if that is part of it. From your Vantage Point what is the origin of this confusion and misunderstanding . With the mayor of london . The mayor and many others feel that the president took those comments out of context with an emotional difficult experience for the londoners the president has been extremely clear that we stand in complete solidarity with the United Kingdom and protecting their relationship and partnership been fully committed to do everything we can to help them in this process and we condemn any act even similar to that. But with this travel ban when you talk about extreme betting but if he tries to get this to go through . Again and now, eight times a half to answer this question today but i will try one more time. I think the president is not concerned with what you call a but with National Security to protect people in this country if you call a travel ban. He is not being politically correct is protecting the American People that is the bottom line. He will take whatever steps he can. But with this going from extreme vetting or travel billion. I dont think he thinks any steps that he takes toward moving the ball forward or protecting the American People for implementing the executive order will ever be a mistake where is sean . He is here today this is part of my job as all the driver asked any the other Deputy Press Secretaries . Is the in a new position . He is taking on some extra duties at this point. He is probably ben upgraded because we do not have a Communications Director. There are a lot of demands on his schedule especially there is not a Communications Director this is part of my job as well end i will step in when needed. But washington suggested in fact, he was given a draft of his speech to the nato partners to respect article five commitments Administration Official told us flatly so who gave that speech . I am not aware i will let you know,. Thanks. [inaudible conversations]
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