The Biden administration’s pick to serve as the second-in-command at the Department of Veterans Affairs expects to make the rollout of a new Electronic Health Record and toxic-exposure legislation her top priorities, if confirmed.

VA Chief of Staff Tanya Bradsher, President Joe Biden’s nominee to serve as deputy VA secretary, told the Senate VA Committee on Wednesday that the VA will only resume go-lives of the Oracle-Cerner EHR “when it is fully ready,” and shows improvement at the five VA sites already using it. 

“We simply have to have an electronic health care record that our veterans can rely on,” Bradsher said.

Bradsher said her top priorities for the new job include holding Oracle-Cerner accountable for the successful rollout of the new EHR, as well as encouraging eligible veterans to apply for health care and benefits under the PACT Act.

The PACT Act expands VA health care and benefits eligibility for veterans exposed to toxic substances during their military service.

The VA is currently in a “reset” period with EHR go-lives, and won’t schedule new EHR deployments until the department is confident that the system shows improvement at the five current sites using the system. However, Bradsher said the VA needs to do more to improve EHR functionality for VA employees already using the Oracle-Cerner system.

“Our clinicians have not seen the results of their comments come back and executed within the electronic health care record,” Bradsher said.

Bradsher said she’d take a “boots-on-the ground” approach to the EHR rollout and would rely on feedback from the five VA sites already using the Oracle-Cerner system.

“We have the opportunity now, with the reset of the five sites, to make sure that we’re able to incorporate those recommendations enterprise-wide, because we can’t have five different records. We need to have enterprise-wide changes, and ensure that we hold Cerner-Oracle accountable so that those changes actually happen,” Bradsher said.

Sen. Patty Murray (D-Wash.) said she continues to hear from veterans and VA employees at VA medical centers in Spokane and Walla Walla, Washington, who feel that their feedback on the new EHR “is not being taken into account or even heard.”

“As you know, it has really put a strain on our providers and on our veterans,” Murray said.

The VA recently renewed its multibillion-dollar contract with Oracle-Cerner, with new terms meant to hold the vendor accountable for persistent outages.

If the new contract terms had been in place since the original contract was signed in 2018, the VA said it would have recovered 30 times as much money back from Oracle-Cerner for EHR system outages.

“We have the ability to hold Oracle-Cerner accountable in ways that the previous contract did not,” Bradsher said, adding that the new contract holds the vendor to a higher standard for keeping the system up and running.

“The changes that we will make don’t just benefit VA, they’ll also benefit DoD and being able to ensure especially with the outages we’ve had definitely some issues with consistency and keeping the system up,” she added.

If confirmed, Bradsher would be one of the most senior VA officials to oversee the VA’s troubled rollout of the multi-billion-dollar EHR from Oracle-Cerner. She’d also be the first woman to serve as VA deputy secretary.

Former VA Deputy Secretary Donald Remy stepped down in April.

Committee Chairman Jon Tester (D-Mont.) told Bradsher the EHR would “take up a good portion of your time,” but said she’d also lead over several other critical management responsibilities at VA.

Bradsher, an Army combat veteran with more than 20 years of service, said she would additionally focus on improving outreach to new veterans who are transitioning out of active-duty military service.

Bradsher further said she’s focused on rebuilding trust with and reaching out to “untethered veterans,” who have never opted into VA care or benefits.

“I’ve seen what it looks like when one of my fellow soldiers transitions out of the military and gets the support they deserve from the VA, how they live happier, healthier and more fulfilled lives,” she said. “ I’ve also seen what it looks like when that doesn’t happen.”

Bradsher said her own father, also a veteran, struggled to find support from the VA system, and “because of that, never quite found his way,” after 22 years of honorable service.

The VA estimates that about 3 million veterans are eligible for health care and benefits under the PACT Act. More than 84,000 veterans so far have enrolled in VA health care under the PACT Act.

Bradsher said she’s spoken to VA employees who are veterans, but didn’t realize they are eligible for health care and benefits under the PACT Act.

“It can’t just be through just [military service organizations] and [veteran service organizations]. We’re going to have to get creative, and we’re going to have to reach the veterans where they are,” she said.

Since President Joe Biden signed the PACT Act into law last August, the VA has held hundreds of events across the country to get the word out to eligible veterans.

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