VA postponing rollout of new electronic health record system

The Department of Veterans Affairs has postponed the rollout of a new electronic health record system at some facilities until 2023, as the project has gained more criticism.

Federal watchdogs and lawmakers have faulted the VA for the management of the project, with a price tag of $16 billion.

The latest controversy emerged when The Spokesman-Review in Washington reported 148 patients had been harmed due to problems with the new system. The news organization cited the findings of a draft report from the VA’s Office of Inspector General.

The VA has planned to install the new system at other facilities this year, but the department said it will hold off on some planned roll-outs until next year.

The department is postponing the launch of the new system at the Puget Sound VA Health Care System from August 2022 to March 2023, a VA spokesman said in an email to Chief Healthcare Executive. The VA Portland Health Care System was slated to get the new system in November 2022, but that has been pushed back to April 2023.

“In evaluating Puget Sound’s and Portland’s readiness for deployment, VA determined the system hadn’t shown adequate reliability to support the current schedule,” the VA spokesman said.

The VA awarded a 10-year contract for the modernization project to Cerner in 2018, Earlier this month, Oracle completed its $28 billion acquisition of Cerner.

Part of the reason for the delay in going live in the facilities is to allow Oracle Cerner time to make changes, the VA spokesman said.

The VA spokesman said there have been “unanticipated outages and system degradations from the onset of the new EHR rollout.” To address those issues, the VA has asked Oracle Center to put in a plan to regularly test the system and ensure its reliability, the spokesman said.

“The revised deployment schedule will enable Oracle Cerner to address these potential gaps in system reliability, particularly in the more complex sites that are upcoming, such as Puget Sound and Portland,” the VA spokesman said via email.

An Oracle executive told the Spokesman-Review that the company is putting more resources into the project and plans to ensure the modernization meets the VA’s expectations.

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The VA still plans to install the new record system at a veterans hospital in Boise, Idaho on July 23, the spokesman told Chief Healthcare Executive.

'Inexcusably broken system'

The VA has said the new record system is essential to improving medical care for 9 million veterans.

The department launched the new electronic record system at the Mann-Grandstaff VA Medical Center, a veterans’ hospital in Spokane, Washington in 2020. But the new system has had issues. In March, the record system had to be taken offline temporarily after a problem affecting patient records, which delayed some services.

The new system went live at the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, Wash. in March 2022. The VA launched the system at a third facility, the VA Central Ohio Healthcare System in Columbus, Ohio, in April.

Federal lawmakers have voiced repeated concerns over issues with the modernization project.

U.S. Sen. Patty Murray, a Democrat from Washington, welcomed the news that the VA is going to put the brakes on launching the system in other veterans’ hospitals.

“I’m glad I could convince VA to finally delay its rollout of what is clearly an inexcusably broken system in Washington state—its expansion into a larger more complex facility like VA Puget Sound Health Care System could have been catastrophic—and worse than what we’ve already seen in Spokane,” Murray said in a statement Tuesday.

“However, I am still very focused on holding VA and Cerner accountable in getting this right for our veterans and the dedicated VA staff in Spokane and Walla Walla—this needs to get fixed, period.”

U.S. Rep. Cathy McMorris Rodgers, a Republican from Washington, said in a statement she was “outraged” by the reports that patients have been harmed due to problems with the new system.

“I’ve had numerous conversations with both VA and Cerner leadership, in which I repeatedly raised concerns about ongoing problems with the system,” she said in the statement. “Time and time again, my concerns—and the valid concerns raised by veterans and providers—were dismissed.”

11,000 lost orders

The inspector general’s draft report found that the new electronic record system failed to deliver more than 11,000 orders for healthcare services, and providers weren’t informed the orders were lost, the Spokesman-Review reported.

The lost orders delayed care and led to dozens of incidents of moderate harm to patients, and one instance of “major harm,” the news organization reported.

The draft report hasn’t been finalized and could be revised before publication, the Spokesman-Review reported.

The Senate unanimously approved a bill last month requiring the VA to provide regular updates to Congress on the electronic health record system. The bill, previously approved by the House of Representatives, was sent to President Biden.

Previous federal reports have identified problems with the VA’s new electronic record system and its management of the project.

​​The U.S. Government Accountability Office said in February the VA needs to address issues in the modernization that could affect patient safety, including errors in medication and allergy data in electronic records.

After initially awarding a 10-year, $10 billion contract to Cerner, the VA later revised the project’s cost to $16 billion. A report issued by the VA’s Inspector General in May 2021 said the VA could have underestimated the costs by as much as $2.6 billion.

The project was also hampered by the emergence of the COVID-19 pandemic in 2020.

The VA has said it expects the new health record system to be installed nationwide by 2028.

The department says the new system will connect the VA’s medical facilities with the Department of Defense and other providers to provide better access to health records and improve care for America’s veterans.