The Department of Veterans Affairs decided to pause the initial rollout of its multibillion dollar electronic health record amid new issues in configuring the system to meet VA’s needs and integrating it with other portions of the department’s IT infrastructure.
The Electronic Health Record Modernization (EHRM) program was to have been switched on at its first site, the Mann-Grandstaff VA Medical Center in Spokane, Washington, next month. But the department notified lawmakers on Monday that the rollout will be delayed.
“Members of Congress have urged the department not to rush its electronic health record modernization efforts. VA leaders have heard that call, and are proceeding deliberately and thoughtfully to adhere to the project’s ten-year timeline, which calls for a rolling implementation schedule through 2027,” Christina Mandreucci, a department spokeswoman said in a statement. “After rigorous testing of our new EHR, the department will need more time to complete the system build and ensure clinicians and other users are properly trained on it. We believe we are 75-80 percent complete in this regard and will be announcing a revised ‘go-live’ schedule in the coming weeks.”
VA is conducting the first round of EHR deployments in the Pacific Northwest to match the Defense Department’s initial rollouts of its MHS Genesis health record. Both systems are based on Cerner’s Millennium platform.
VA’s 2021 budget proposal, also released on Monday, does not explicitly mention delays in the EHRM rollout. However, its IT budget does describe the health record’s crucial interdependencies with other VA IT systems that are being deployed and upgraded in parallel, including, for example, the Defense Medical Logistics Standard Support (DMLSS).
That system, run by the Defense Health Agency, is meant to replace a series of aging legacy systems VA currently uses to manage its supply chain for medical supplies.
“[VA] has identified DMLSS as a key dependency for EHRM’s successful deployment. This requires that DMLSS IOC sites align with upcoming EHRM rollouts with adequate time for integration development and testing prior to EHRM Go Live,” officials wrote in the budget submission. “The highest priority for the DMLSS IOC effort is to ensure that the EHRM IOC sites have successfully deployed DMLSS prior to the planned two EHRM IOC sites (Mann-Grandstaff (Spokane) and Seattle/American Lake (Puget Sound)).”
According to the budget proposal, VA plans to spend $2.6 billion to fully-deploy the system in northern California and Nevada and in portions of the southwestern and southeastern U.S. Almost half that amount is for IT infrastructure upgrades that must be installed before the EHRM system itself can function properly.
As recently as last week, Robert Wilkie, the VA secretary, said the department still planned to deploy the new Cerner EHR at its first site in March. At the time, he was responding to questions about whether the EHRM program would be affected by the still-unexplained firing of James Byrne, the former deputy secretary who was spearheading the EHR implementation.
“I don’t think it’ll impact it at all,” he told reporters at the National Press Club on Wednesday. ““I sat down with the Secretary of Defense about a week ago to discuss where we are. This is a joint partnership with the Department of Defense. We are doing well, and MISSION Act [implementation] shows that this VA is capable of pulling off enormously complex programs. I expect us to do well with this venture, as we did with MISSION.”
In a joint statement, Reps. Phil Roe (R-Tenn.) and Jim Banks (R-Ind.), the ranking members of the Veterans Affairs Committee and its technology modernization subcommittee, said they would rather see the department deploy the new system correctly than stick rigidly to its original timetable.
“With a project as complex, costly, and impactful as this one, the worst thing VA could do is jump the gun,” they said. “We applaud VA for recognizing that more training and preparation is needed and taking the time to get this right. We hope that VA will be able to move forward with the complete Cerner system in Spokane to deliver the best possible veteran experience, and we look forward to continuing the committee’s oversight of this project to achieve a fully interoperable health records system for the millions of men and women who have served.”