VA says it is working to improve electronic health record project

The Department of Veterans Affairs says it is continuing to work with Oracle Cerner on the modernization of its electronic health record system, a project that has rankled lawmakers.

The VA said last week that it is postponing the deployment of the new system until June 2023 to address a host of problems, including some that could affect patient safety. The VA initially tapped Cerner for the project in 2018. Oracle acquired Cerner in a $28 billion deal in June.

Several technical and system issues were identified that impacted patient scheduling, referrals, medication management, and other types of clinical orders, a VA spokesperson told Chief Healthcare Executive in an email this week.

“VA is taking a coordinated approach across the enterprise to identify and prioritize the efforts necessary to address these areas of concern, engage with Oracle Cerner, and implement the actions needed to ensure a safe transition to the new system,” the VA spokesperson said.

In response to a question about when the VA expects the new electronic health record system to be up and running, the spokesperson responded, “VA is continuing to evaluate lessons learned, which will be incorporated into a revised deployment schedule for the new EHR. An updated schedule will be shared once approved.”

“As of now, VA is planning to resume deployments in June 2023 and will continue to assess people, process and technology readiness at each site,” the spokesperson said.

The VA announced last week that it was delaying the rollout because an investigation of the five facilities that are using the new system have identified a number of deficiencies.

The problems include “latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders,” the VA said in an Oct. 13 news release.

The VA said it is working with Oracle Center to fix the problems with the system and provide a better health record system for veterans. The VA spokesperson said Oracle Cerner is making progress.

“Oracle Cerner has been responsive in progressively remediating capacity and stability issues with the EHR and is working on improving their overall quality of service,” the VA spokesperson said.

The VA said it is reaching out to veterans to determine if they have had delays in appointments or medications.

The mailings are still taking place this week, so it’s unclear just how many veterans are being contacted, but the VA spokesperson said mailings have gone out to about 41,500 veterans across the five facilities with the new health record system.

Lawmakers and federal watchdogs have criticized the VA's management of the project for years. In 2018, the VA awarded a $10 billion, 10-year contract with Cerner to upgrade the system, but the department later revised the cost to $16 billion.

The department launched the new electronic record system at the Mann-Grandstaff VA Medical Center in Spokane, Washington in 2020, but the deployment has suffered a series of problems. In March, the record system had to be taken offline temporarily after a problem affecting patient records, which delayed some services.

The inspector general released a report in July, which found the new system at the Spokane hospital failed to deliver more than 11,000 orders for clinical services between October 2020 and June 2021. The inspector general also identified 149 adverse events for patients.

U.S. Sen. Patty Murray, D-Washington, has repeatedly criticized the project for years. After the VA announced the deployment of the new system will be delayed until June, Murray said last week she will keep pushing until the issues are addressed.

“I have been incredibly frustrated by how the botched rollout of the Oracle Cerner EHR system has hurt veterans and undermined hardworking VA providers and staff in Washington state,” Murray said in a statement.

“I don’t want to see this rollout move forward one inch until the system is fully fixed,” she added.

Deputy Secretary of Veterans Affairs Donald Remy, who oversees VA’s EHR program, said in a statement last week that the new system won’t go out to other facilities until all the problems are resolved. Remy said the new system “is not delivering for Veterans or VA health care providers – and we are holding Oracle Cerner and ourselves accountable to get this right.”

President Biden signed legislation in June requiring the VA to provide quarterly updates on the cost, progress and performance of the electronic health record project.

The VA said it remains committed to modernizing the electronic health record system, and said the new system will offer better documentation and support for veterans. The VA eventually aims to link the system with the Department of Defense health record system, which the department said will improve care for service members and veterans.