VA delays rollout of new electronic health record system again

The Department of Veterans Affairs announced on Thursday that it is extending the pause on future deployments of its new multi-billion dollar Oracle Cerner electronic health record system, which were set to restart in June after an eight-month delay that was meant to help resolve issues with the software’s performance. 

VA’s Electronic Health Record Modernization program, which is designed to replace the department’s legacy system—the Veterans Health Information Systems and Technology Architecture, or VistA—has been beset by technical outages, performance and usability concerns and patient safety issues since the Oracle Cerner software was first deployed at the Mann-Grandstaff VA Medical Center in Spokane, Washington in 2020. Cerner, which was acquired by Oracle in June 2022, won a $10 billion contract in 2018 to replace VistA, but the new EHR system has only been deployed at five facilities across the VA’s national network of 171 medical centers.

Under the go-ahead of VA Secretary Denis McDonough, department officials announced last October that they were delaying future deployments of the Oracle Cerner system until June 2023 to conduct an “assess and address period” that would “correct outstanding issues—especially those that may have patient safety implications—before restarting deployments at other VA medical centers.” That October announcement followed a July 2022 decision to suspend all scheduled deployments of the new software at VA medical facilities until early 2023. 

VA planned to restart its rollout of the Oracle Cerner system in June at the VA Saginaw Healthcare System in Michigan, but Thursday’s announcement has indefinitely postponed the site’s scheduled deployment.

In a letter to Saginaw employees on Thursday that was viewed by Nextgov, Laura Ruzick, director of Veterans Integrated Services Network 10—which includes VA medical centers, outpatient clinics and an ambulatory care clinic across most of Indiana, northern Kentucky, Michigan and Ohio—said that “based on our recent assessments, including the ongoing ‘assess and address’ period and the readiness assessment, we have determined that the new EHR is not yet ready for the planned June deployment in Saginaw.”

Ruzick added that the EHR system training for facility staffers, which was scheduled to begin on April 11, would also be postponed, and that VA “will have more updates for you in the coming weeks on the path forward.”

“I am confident that when we do roll out the new EHR system in Saginaw, we will make it a smooth, safe and positive experience for veterans and staff alike—and we will do so together,” Ruzick said.

VA previously announced in February that it was delaying plans to deploy the new Oracle Cerner system at the VA Ann Arbor Healthcare System in Michigan until later this year or in early 2024. That rollout was initially scheduled to occur in July.

The decision to extend the delay on future rollouts was met with bipartisan support, with lawmakers highlighting the need for VA to refrain from any additional deployments of the EHR system until technical and performance issues with the software have been remedied. 

In a joint statement, Rep. Mike Bost, R-Ill.—chair of the House Veterans’ Affairs Committee—and Rep. Matt Rosendale, R-Mont.—chair of the House Veterans' Affairs Subcommittee on Technology Modernization—said “we applaud Secretary McDonough’s responsible decision not to resume implementing the disastrous Oracle Cerner electronic health record at more VA sites.”

“It is abundantly clear to us that the Oracle Cerner EHR system is not ready for prime time, and VA is not ready to carry out this project,” the lawmakers added. “Local VA medical center leadership and staff have said so themselves for months. This pause should last as long as it takes for VA and Oracle Cerner to get their houses in order. That may be years, but the delivery of good care and services to veterans depends on it.”

Bost, along with 10 Republican co-sponsors, introduced legislation in late January that would prevent VA from deploying the new EHR system at any additional medical facilities until the sites certify in writing to McDonough that the Oracle Cerner software has met certain performance and facility readiness standards. Rosendale also introduced legislation in late January—co-sponsored by Bost—that would “end the Oracle Cerner electronic health record program at VA if it cannot demonstrate significant improvement but is nonetheless introduced to additional medical centers.” 

Bost told Nextgov in an interview last month that “it’s Cerner and Oracle that need to get their act together,” adding that “VA simply has to make sure that, at the place where they're going to roll it out, the standards are met.” He said at the time that VA was not ready to continue future deployments of the system until officials fully addressed performance and technical issues—a sentiment, he added, that has bipartisan and bicameral support.

In an emailed statement to Nextgov, Sen. Jon Tester, D-Mont.—chair of the Senate Veterans’ Affairs Committee—said “I’m glad VA listened to my call to delay future rollouts of the EHRM system.”

“This is the right decision for veterans and the dedicated VA employees who serve them, and I’ll keep holding VA and Oracle Cerner accountable in negotiating a new contract that protects taxpayers and delivers an electronic health record that provides care safely,” Tester added. 

During a March 15 committee hearing, Tester noted that VA’s current contract with Oracle Cerner is set to expire May 16, and called for McDonough to “bring together government and industry best contract experts and renegotiate the Oracle Cerner contract.” 

McDonough, who later testified at a March 29 House Appropriations Committee hearing, told lawmakers at the time that VA had not yet made a decision about whether to move forward with deploying the Oracle Cerner system at Saginaw, but said, in part, that “I need to see what happens in this contract before we make a decision about where we go next anyway, because the contract may not be what we need.”

Tester, along with two other committee members—Sens. Patty Murray, D-Wash., and Sherrod Brown, D-Ohio—also announced on March 29 that they plan to introduce legislation that “would restructure, enhance and strengthen the entire EHRM program while also mandating aggressive reporting to Congress to increase oversight, accountability and transparency following a series of challenges with the system and program.” 

The senators said their legislation would, in part, address technology issues identified in a report on the EHRM program that VA released last month, which included “recommended solutions for the most impactful and critical patient safety issues.”

The Democrats’ announcement came the same day that Sen. Jerry Moran, R-Kan.—the panel’s ranking member—and 11 Republican co-sponsors introduced legislation that would prevent VA from moving forward with future deployments of the Oracle Cerner system “until certification of system stability improvements.”