Lawmakers Grill Officials Over Flawed VA Electronic Health Record System Rollout

Lawmakers Grill Officials Over Flawed VA Electronic Health Record System Rollout
The Mann-Grandstaff VA Medical Center in Spokane, Wash., was the first facility to roll out the VA's new electronic health care record system. (VA via Facebook)

Lawmakers are running out of patience with the VA’s rollout efforts of its new electronic health record modernization (EHRM) program.


Notable frustrations surfaced during a Senate Veterans’ Affairs Committee hearing March 15, in which committee members intensely questioned officials from the VA, Oracle Cerner (the current contractor), and the Government Accountability Office (GAO) to find out what the department has done since pausing the project back in October.


Members have been waiting to see if the electronic record is a “go or no go” for the projected summertime restart of the $10 billion and growing amount Congress has ready plowed into the VA system. There has been growing concern in both chambers and both sides of the aisle over patient harm and lingering technical problems since the system’s first rollout in October 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Wash.


Like Congress, MOAA and veterans want the VA to get this project right, but also want to see more visible progress and transparency from the VA going forward. Regardless of the path forward at the end of the day, the health and safety of veterans is first and foremost.


[RELATED: VA Delays Health Record Rollout Again, This Time Until Summer 2023]


The committee chair, Sen, Jon Tester (D-Mont.) made similar sentiments clear in his opening statement: “We need to know where the hell we’re at, where we’re going, what it’s going to cost, and when we can look for a timely delivery of a thing that we’ve been talking about here for 20 years.”


Members of the committee also were adamant about the project not moving forward without fixing technical problems, and with an assurance patient safety measures would be in place to prevent harm to veterans.


Hearing Revelations

Sen. Jerry Moran (R-Kan.), the committee’s ranking member, raised doubts about VA’s ability to successfully implement the EHRM program.


“Delays, rising costs, unintended impact on veterans is unacceptable from programs aimed at serving them,” Moran said in his opening statement, adding that “fixes are months or years down the road. We’ve failed to see progress in the management of the system during program pauses that will make future implementation successful.”


However, VA officials and Oracle Cerner representatives remained firm on their ability to successfully restart the program and achieve congressional intent to have a fully interoperable system that that serves as a single system for VA and DoD, including the U.S. Coast Guard, so government and community providers can access patient history and a system that helps create a more seamless health care experience for servicemembers and veterans.


Speakers with both the VA and GAO assured the committee fixes would be completed and the system would not launch to future sites until safety, technical, and usability issues are resolved and each site is ready to go live.


[RELATED: Veterans' Emergency Room Bills Could Get Repaid by VA Thanks to Change]


Yet a staffer with GAO, which has been auditing the project since its inception in 2017, told members the contractor has not performed as well as it should have given the volume and severity of the system issues and the lack of timeliness in resolving issues.


“The other piece is the oversight of VA — this is a new thing to VA,” said Carol Harris, director of GAO’s information technology office. “VA has been in a position for 40 years of building systems like its current Veterans Health Information Systems and Technology Architecture (VistA) — an electronic health record used since the 1980s. A completely different skill set is required for buying technology systems. VA is struggling at the transition to a new system as evident by several past failed attempts and what we see going on today.”


Current Issues

Harris highlighted three key points around VA’s current change management challenges outlined in a recent audit. Successful implementation will require:

  • Improved level of program management.
  • Improved organizational adaptability to change.
  • Sustained system performance.


Most users expressed dissatisfaction with performance and training related to the new system, and the VA has no way of measuring satisfaction. The VA should set goals to sufficiently measure this critical component of the process.


Additionally, VA has not conducted an independent assessment of the system. In contrast, DoD conducted an independent assessment after its first military health system GENESIS EHRM program launch — DoD paused deployment based on the assessment until fixes were made, a move which helped accelerate future launches. Today, GENESIS has been implemented across 75% of the military health system.


While the system is not without risk, Harris told the committee that the VA can achieve success if it employs strong oversight, program management, and contractor performance, as well as implementing GAO’s recommendations.   


The Future of VA’s EHRM Program

The contract for the records system expires in two months, and the VA has started renegotiating the Oracle Cerner deal for a new option period. VA and contactor officials assured the committee each organization has the right people and enforcement mechanisms in place to make this system work, and that the overall result will be the best solution for taxpayers.


A few days before the Senate committee hearing, the House Veterans Affairs’ Subcommittee on Technology Modernization held a hearing to discuss VistA and voiced similar concerns about the new VA EHRM program. While the VA plans to continue to using VistA until the new EHRM system is fully implemented, some members have introduced legislation that would either halt future deployments until fixes, performance, and patient safety criteria are met, or would look at enhancing VistA rather than continuing to invest in a new system.


What is clear is more oversight hearings, more scrutiny, and more accountability of VA’s EHRM project are on the horizon.


[RELATED: MOAA Testimony to Joint Congressional Panel Outlines Key Priorities for Veterans]


“Members here [on the committee] are all driven by the same expectation, that is making sure veterans get the care they earned in a way that they deserve,” Tester said in closing out last week’s Senate hearing.


MOAA agrees. What most can agree on is the status quo is not an option, and we must see results. MOAA will do all it can to help Congress and the VA to successfully modernize the department’s electronic health record system.


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About the Author

Cmdr. René Campos, USN (Ret)
Cmdr. René Campos, USN (Ret)

Campos currently serves as MOAA's Senior Director of Government Relations, managing matters related to military and veterans’ health care, wounded, ill and injured, and caregiver policy.