pursuant to the memorandum of understanding between the Secretary of Veterans Affairs and the Administrator of the Centers for Medicare & Medicaid Services under section 6(a). (c) Definitions In this section: (1) Medicaid The term Medicaid means the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.). (2) Medicare The term Medicare means the Medicare program under title XVIII of such Act ( 42 U.S.C. 1395 et seq.). 8. Analysis of electronic health record of Department of Veterans Affairs (a) In general The Chief Information Officer of the Veterans Health Administration, in partnership with the Chief Information Officer of the Department of Veterans Affairs, shall conduct a comprehensive cost-benefit analysis among selecting a commercial off-the-shelf electronic health record, selecting an open source electronic health record, or continuing the in-house custom development of the VistA electronic health record currently in use by the Veterans Health Administration. (b) Elements The analysis conducted under subsection (a) shall— (1) take into account the complexities of the computerized patient record system architecture and infrastructure of the VistA electronic health record and known issues with performance, scalability, extensibility, interoperability, and security of such health record