As the Department of Veterans Affairs (VA) is preparing to restart deployment activities for its Electronic Health Records Modernization (EHRM) program in fiscal year (FY) 2025, lawmakers are asking the agency to hold off – and in the words of one of them – to avoid a potential “disaster.”
The EHRM program aims to provide a seamless experience for veterans as they transition from receiving care under the Department of Defense (DoD) to receiving care under the VA, with a single fully integrated EHR system.
However, the program is currently in the middle of a “program reset,” while the VA and contractor Oracle Cerner focus on improvements at the six sites where the EHR system is currently deployed.
In March, the VA deployed its EHR system at the Captain James A. Lovell Federal Health Care Center (Lovell) near Chicago – the only healthcare facility to serve both DoD and VA patients.
While the VA is calling Lovell its “most successful deployment” yet, members of the House VA Technology Modernization Subcommittee are not convinced – especially because it is the only site that also has DoD’s support.
“Make no mistake, despite all the spin, the problems have not disappeared,” subcommittee Chairman Matt Rosendale, R-Mont., said during a hearing late Monday. “As a large, complex medical center, Lovell has revealed new flaws in the Oracle Cerner EHR.”
Rep. Rosendale said committee staff visited Lovell twice and found that the employees are “reporting the same frustration, hypervigilance, and burnout” that employees at other VA sites reported last fall.
“I have serious concerns that Secretary McDonough is about to put the Department of Veterans Affairs, and the veterans it cares for, in a dangerous situation by resuming the go-lives on a large scale,” Rep. Rosendale said. “If VA is not able to or willing to provide the same level of support they did for James A. Lovell at other medical centers, the result could be a disaster.”
“While [Lovell] may have been more successful than previous attempts, I think we are far from ready to endorse further go-live activities,” added Ranking Member Sheila Cherfilus-McCormick, D-Fla. “[Lovell] had the luxury of being the sole focus of both VA and DoD’s EHR modernization programs. The two departments threw more resources at this go-live than ever than will ever be available at any future VA facility.”
The VA has the support of 100 additional staff members to assist with the Lovell deployment, and it has requested the help of an additional 100 more employees.
The supplemental staff has helped to handle the majority of the workload of the EHR system’s pharmacy software functions. With the current system, the permanent pharmacy staff are only able to process about 40 percent of the prescriptions, according to Rep. Rosendale.
Earlier this year, the VA Office of Inspector General revealed that the new EHR system caused pharmacy-related patient safety issues. VA is working to address these issues, including what is known as the “pharmacy 3b/3c feature,” which will keep the prescription information between ordering clinicians and the pharmacy team in sync.
However, Neil Evans, acting program executive director of the EHRM Integration Office, said the VA does not expect to fix this pharmacy issue until February 2025.
Rep. Mike Bost, R-Ill., chairman of the full House VA Committee, joined the subcommittee hearing on Monday to express his frustration with the EHRM program’s ongoing delays. The congressman explained that when Oracle purchased Cerner in December 2021, an Oracle executive told him, “If a person tells you in this industry that they can’t fix a problem in six months they don’t know what they’re doing.”
With continued ongoing delays, Rep. Bost stressed that the VA should not be waving “a flag that you’re doing well” at Lovell when it’s the only healthcare facility that also has DoD’s support.
“I don’t know how to fix it because we’re so far down the road that we can’t put on the brakes,” he added. “And the bad thing is it should have been very simple to adjust and now here we are, not slightly over budget, way over budget. We only have six facilities even started to be turned up, and this has been a boondoggle from the very beginning. I’m very disappointed.”
The VA witnesses were unable to give a complete lifecycle cost estimate for the program – which has a current budget of $16 billion. However, an independent life cycle cost estimate by the Institute for Defense Analysis in 2022 said it exceeds $50 billion.
