IIB 
117TH CONGRESS 
1ST SESSION H. R. 4591 
IN THE SENATE OF THE UNITED STATES 
NOVEMBER 17, 2021 
Received; read twice and referred to the Committee on Veterans’ Affairs 
AN ACT 
To direct the Secretary of Veterans Affairs to submit to 
Congress periodic reports on the costs, performance 
metrics, and outcomes of the Department of Veterans 
Affairs Electronic Health Record Modernization pro-
gram. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘VA Electronic Health 
Record Transparency Act of 2021’’. 
SEC. 2. REPORTS ON COSTS, PERFORMANCE METRICS, AND 
OUTCOMES OF DEPARTMENT OF VETERANS 
AFFAIRS 
ELECTRONIC 
HEALTH 
RECORD 
MODERNIZATION PROGRAM. 
(a) IN GENERAL.—Section 503 of the Veterans Bene-
fits and Transition Act of 2018 (Public Law 115–407; 38 
U.S.C. 5701 note prec.) is amended— 
(1) by redesignating subsection (e) as sub-
section (f); 
(2) by inserting after subsection (d) the fol-
lowing new subsection (e): 
‘‘(e) QUARTERLY REPORTS.— 
‘‘(1) REPORTS ON COSTS OF EHRM PROGRAM.— 
Not later than 90 days after the date of the enact-
ment of the VA Electronic Health Record Trans-
parency Act of 2021, and every 30 days after the 
last day of each fiscal quarter thereafter until the 
termination date specified in paragraph (3), the Sec-
retary of Veterans Affairs shall submit to the Com-
mittees on Veterans’ Affairs of the Senate and 
House of Representatives a report on the costs of 
the Electronic Health Record Modernization pro-
gram of the Department of Veterans Affairs. Each 
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such report shall include, for the period covered by 
the report and for the total period beginning on the 
date of the enactment of the VA Electronic Health 
Record Transparency Act of 2021 and ending on the 
date of the submittal of the report, a description of 
all actual expenses of, and driven by, such program, 
including any such expenses paid using— 
‘‘(A) any funds appropriated for the De-
partment of Veterans Affairs, for any source or 
account, expended by any organizational ele-
ment of the Department or by the Federal 
Electronic Health Record Modernization Office 
for the Electronic Health Record Modernization 
Program; 
‘‘(B) any funds, from any source or ac-
count, expended by any organizational element 
of the Department for physical or technology 
infrastructure modifications, enhancements, im-
provements, or expansions at a facility of the 
Department necessitated by, or related or per-
taining to, the Electronic Health Record Mod-
ernization Program; and 
‘‘(C) any funds, from any source or ac-
count, expended by any organizational element 
of the Department or by the Federal Electronic 
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Health Record Modernization Office for con-
sultants, support contractors, or experts related 
or pertaining to the Electronic Health Record 
Modernization Program. 
‘‘(2) REPORTS ON PERFORMANCE METRICS AND 
OUTCOMES.—Not later than 90 days after the date 
of the enactment of the VA Electronic Health 
Record Transparency Act of 2021, and every 30 
days after the last day of each fiscal quarter there-
after until the termination date specified in para-
graph (3), the Secretary of Veterans Affairs shall 
submit to the Committees on Veterans’ Affairs of 
the Senate and House of Representatives a report on 
the performance metrics and outcomes of the Elec-
tronic Health Record Modernization Program. Each 
such report shall include, for the period covered by 
the report— 
‘‘(A) a list of the quality, performance, 
safety, or value metrics, key performance indi-
cators, and other diagnostic or evaluation cri-
teria in use to assess the Electronic Health 
Record Modernization Program and the elec-
tronic health record system, in general and at 
individual facilities, with respect to veterans, 
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employees of the Department, and Depart-
mental operations; 
‘‘(B) an explanation of any change to any 
of such metrics, indicators, and criteria com-
pared to the metrics, indicators, and criteria in-
cluded in any previous report submitted under 
this paragraph; 
‘‘(C) the data supporting or demonstrating 
each such metric, indicator, and criteria com-
pared to the data supporting or demonstrating 
such metric, indicator, or criteria as included in 
the previous report submitted under this para-
graph; and 
‘‘(D) a list of patient safety reports, inci-
dents, alerts, or disclosures at each facility of 
the Department where the electronic health 
record system has been implemented. 
‘‘(3) TERMINATION DATE.—The requirement to 
submit a report under paragraph (1) shall terminate 
on the date that is 90 days after the date on which 
the Secretary submits to the Committees on Vet-
erans’ Affairs of the Senate and House of Rep-
resentatives certification that the Electronic Health 
Record Modernization program has been fully imple-
mented.’’; and 
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(3) in subsection (f), as redesignated by para-
graph (1), by adding at the end the following new 
paragraphs: 
‘‘(3) The term ‘electronic health record system’ 
means the electronic health record system imple-
mented pursuant to the Electronic Health Record 
Modernization Program. 
‘‘(4) The term ‘Federal Electronic Health 
Record Management Office’ means the office estab-
lished under section 1635(b) of the Wounded War-
rior Act (title XVI of Public Law 110–181; 10 
U.S.C. 1071 note). 
‘‘(5) The term ‘facility of the Department’ in-
cludes a joint facility of the Department of Veterans 
Affairs and the Department of Defense.’’. 
Passed the House of Representatives November 16, 
2021. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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