House bill would put a stop to VA EHR modernization

The legislation seeks to end the Oracle Cerner electronic health record rollout and reinstate VistA. Another bill, meanwhile, would only allow new EHRM go-lives after certain clinical certifications.

Citing billions more to be spent over the next several years by the Department of Veterans Affairs on a new electronic health record system that has been fraught with implementation struggles, Rep. Matt Rosendale, R-Mont., say he wants to stop the rollout of the Oracle Cerner EHR system as soon as possible.

WHY IT MATTERS

As he enters his second term serving the House Veterans Affairs Committee, Rosendale will now chair the Subcommittee on Technology Modernization legislative, which oversees and has investigative jurisdiction over the VA's enterprise technology modernization programs and projects.

According to an announcement, the VA EHR termination bill introduced last week  would, within 180 days of passage: 

  • Abolish the Electronic Health Record Modernization Integration Office.
  • Transfer remaining activities to the Veterans Health Administration or Office of Information and Technology. 
  • Revert all medical centers using the Oracle Cerner EHR to VA’s existing EHR platform: the Veterans Health Information Systems and Technology Architecture (VistA). 
  • Gradually wind down the Oracle Cerner contract by preventing the Secretary from exercising any options.

Rosendale has harshly criticized the VA's new EHR since 2021, citing operational inadequacies and the expense of government funding.

Oracle completed its asquisition of Cerner in June at a cost of more than $28 billion.

Rosendale said in his VA EHR termination bill announcement that since 2018, the VA has spent $5 billion on the Oracle Cerner EHR at a handful of its 171 medical centers. 

"Additionally, VA acknowledges that the new system has created unacceptable levels of productivity losses, patient safety risks and staff burnout at these five small and medium-sized facilities," he added.

A separate bill also introduced last week, the VA Electronic Health Record Modernization Improvement ACT, by Rep. Mike Bost, R-Ill., Chair of the House Committee on Veterans' Affairs, would only allow additional VA EHR rollouts planned for 2023 with certification that improvements were made. 

"Specifically, each VA medical center’s director, chief of staff and network director would be required to certify that the EHR system has been correctly configured for the site, the staff and infrastructure are adequate to support it and it would not negatively impact safety, quality or current wait times," according to a fact Sheet about the proposed legislation on the committee's website.

"Additionally, VA and Oracle Cerner could not commence go-live preparations at additional medical centers until the Secretary certifies that the system has achieved 99.9 uptime and technical fixes, as directed in the contract, have been made."

THE LARGER TREND

In July, the VA Office of Inspector General released its final report on The Oracle Cerner EHR deployment at the Man- Grandstaff VA Medical Center, which found 149 instances of patient harm due to a technical glitch.

"From facility go-live in October 2020 through June 2021, the new EHR failed to deliver more than 11,000 orders for requested clinical services," according to the report.

Recent system slowdowns  were reported by the Mann Grandstaff Medical Center, which is located in Spokane, Washington. 

The lag time was caused by an upgrade to the Military Health System's Oracle Cerner EHR – Genesis – which shares a database with the VA, according to the Spokesman-Review's report. 

VA Press Secretary Terrence Hayes confirmed that when the Department of Defense made changes it "had the unintended consequence of interrupting services that provide connectivity to the network."

The DoD is farther along in the implementation of its Oracle Cerner EHR instance, with facilities in multiple states going online with new patient accounting, medical coding, and patient registration and access capabilities.

ON THE RECORD

“The Oracle Cerner electronic health record program is deeply flawed – causing issues for medical staff and posing significant patient safety risks,” said Rosendale in the statement. 

“We cannot continue to further implement this inadequate system at the expense of billions of dollars in government funding. We must hold the VA to the high standard of care promised to our veterans and be good stewards of taxpayer dollars.”