In the latest setback for the initiative, the Department of Veterans Affairs announced that all deployments in its EHR Modernization effort will be halted while it prioritizes improvements at the five sites that currently use the new EHR, as part of a larger program reset.
This “reset” follows an extended pause in deployments that began in July 2022, culminating in an “assess and address” period that identified a long list of necessary fixes. VA has already begun to work through these and other issues and said it would work closely with Oracle Cerner to address all remaining issues.
Statements from VA officials are blunt about the lack of progress. “For the past few years, we’ve tried to fix this plane while flying it – and that hasn’t delivered the results that veterans or our staff deserve,” said Neil Evans, M.D., acting program executive director for the Electronic Health Record Modernization Integration Office, in a statement. “This reset changes that. We are going to take the time necessary to get this right for veterans and VA clinicians alike, and that means focusing our resources solely on improving the EHR at the sites where it is currently in use, and improving its fit for VA more broadly. In doing so, we will enhance the EHR for both current and future users, paving the way for successful future deployments.”
VA and Oracle Cerner are currently working toward an amended contract that will increase Oracle Cerner’s accountability to deliver a high-functioning, high-reliability, world-class EHR system. Also, as part of the re-set, VA will work with Congress on resource requirements. VA estimates FY 2023 costs will be reduced by $400 million.
During this reset, VA says, it will fix the issues that were identified during the recent “assess and address” period, continue to listen to veterans and clinicians about their experience with the EHR, and redirect resources to focus on optimizing the EHR at the sites where it is currently in use: Spokane VA Health Care System, VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care, and VA Central Ohio Health Care System.
“We’ve heard from veterans and VA clinicians that the new electronic health record is not meeting expectations – and we’re holding Oracle Cerner and ourselves accountable to get this right,” said VA Secretary Denis McDonough, in a statement. “This reset period will allow us to focus on fixing what’s wrong, listening to those we serve, and laying the foundation for a modern electronic health record that delivers for veterans and clinicians.”
Additional deployments will not be scheduled until VA is confident that the new EHR is highly functioning at current sites and ready to deliver at future sites. This readiness will be demonstrated by clear improvements in the clinician and veteran experience; sustained high performance and high reliability of the system itself; improved levels of productivity at the sites where the EHR is in use; and more. When these criteria have been met and the reset period concludes, VA said, it will release a new deployment schedule and re-start deployment activities.
The only exception to the full-stop on deployment activities is the Captain James A. Lovell Federal Health Care Center in Chicago – which is the only fully-integrated VA and Department of Defense healthcare system – where the new EHR is scheduled to go-live in March 2024. To ensure that all veterans and service members who visit this facility are covered by one EHR system, deployment activities for this facility, in partnership with DoD and the Federal Electronic Health Record Modernization Office, will continue as planned and leverage the improvements made during the reset.
