Two of the top Republicans on the House Veterans Affairs Committee are leading colleagues in calling on the VA to postpone future rollouts of its new, multibillion-dollar Electronic Health Record until improvements are made.

The VA Electronic Health Record Modernization Improvement Act would require VA, along with vendor Cerner and its parent company, Oracle, to demonstrate “significant improvements” in the EHR system before installing it at additional VA medical centers.

The bill would prevent the VA from implementing the new EHR at additional facilities until the system has achieved 99.9% uptime at VA medical facilities currently running on the new system.

Committee Chairman Mike Bost (R-Ill.) introduced the bill, along with Technology Modernization Subcommittee on Chairman Matt Rosendale (R-Mont.) and eight other House Republicans.

Additional cosponsors include Reps. Cathy McMorris Rodgers (R-Wash.), Mike Carey (R-Ohio), Troy Balderson (R-Ohio), Dan Newhouse (R-Wash.), Mike Simpson (R-Idaho), Cliff Bentz (R-Ore.), Jim Banks (R-Ind.) and Richard Hudson (R-N.C.).

Meanwhile, Rosendale introduced a separate bill last week that would force the VA to completely pull the plug on the Oracle-Cerner EHR. Bost is listed as a cosponsor of the bill.

A spokeswoman for the House VA Committee told Federal News Network on Tuesday that the committee is prioritizing the EHR improvement bill, and that the bill terminating the new EHR program “would be the final step in the event that VA and Oracle-Cerner cannot meet the benchmarks the improvement bill would create.”

“Right now, the focus of the Chairman and the Committee is the improvement bill. We support the intent of the new modernized records system,” the spokeswoman said.

VA Secretary Denis McDonough told reporters on Tuesday that said the VA still has a “particular need” to migrate to an EHR that’s interoperable with the Defense Department.

“We want to be in a position where we can easily access a service member’s records, going back through all of her years in active duty. So our ability to be able to do that with DoD is extraordinarily important,” McDonough said.

Both DoD and the Coast Guard are much further ahead than VA in their implementation of the Oracle-Cerner EHR. The VA has implemented the Oracle-Cerner EHR at five of its 171 medical centers since 2018, and spent about $5 billion on implementation so far.

McDonough told reporters he’s aware that bills targeting the VA’s EHR rollout have been in the works. However, he said staying on course with the Oracle-Cerner EHR rollout will lead to a better experience for VA clinicians and patients.

“What I also hear is something that I know our clinicians, many of our vets, and then [Deputy VA Secretary] Donald [Remy] and I feel, which is frustration that it’s not rolled out more quickly and efficaciously. But we owe it to our vets to get them that modern [electronic health] record,” McDonough said.

McDonough also confirmed the Oracle-Cerner EHR last week experienced a system-wide degradation in performance, which affected every VA facility using the system and DoD’s Military Health System. The Spokesman-Review first reported the system outage on Jan. 24.

“Too often we’re a downstream consumer of this infrastructure, and too often, our concern becomes secondary to, for example, DoD, which manages big parts of the network. And this makes implementation of this system harder than it might otherwise be,” he said.

VA last summer scrapped plans for EHR deployments for the rest of calendar year 2022, after the agency’s inspector general office reported instances of the EHR contributing to patient harm and decreased quality of care. The agency expects to resume EHR go-lives in June 2023.

Bost said in a statement Tuesday that the EHR’s troubled rollout “has crippled the delivery of care, put veteran patient safety at risk, and stressed an already overwhelmed healthcare system.”

“While I commend the Secretary for pausing deployment of the new EHR at future sites, I am not confident that will be enough. It’s simple: the Oracle Cerner system should not be implemented at any more VA sites until the VAMC leadership certifies that the medical center is ready,” Bost said.

Rosendale said the Oracle-Cerner electronic health record is “deeply flawed — causing issues for medical staff and posing patient safety risks.”

“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,” Rosendale said.

McDonough said the VA is working with the Office of Management and Budget to ensure that the Biden administration’s budget request for fiscal 2024 and beyond “reflects our dedication to the program.”

“We’re clear-eyed about the fact that the program has not moved as quickly as was initially planned,” McDonough said.

The VA Electronic Health Record Modernization Improvement Act would require each VA medical center’s director, chief of staff and network director to certify that the EHR system has been correctly configured, and that the facility’s staff and infrastructure are able to support it.

Last Friday, Bost and Rosendale introduced another bill that would terminate the VA’s EHR Modernization Program. FCW first reported the bill’s introduction on Monday.

The VA Electronic Health Record Modernization Termination Act would, within 180 days of being signed into law, abolish the VA’s Electronic Health Record Modernization Integration Office and transfer its operations to the Veterans Health Administration or the VA’s Office of Information and Technology.

The bill would also require the VA to revert all medical centers using the Oracle Cerner EHR to VA’s legacy EHR platform, the Veteran’s Health Information Systems and Technology Architecture (VistA).

Ongoing problems with the VA’s EHR rollout have led to the project falling behind schedule and over budget, frustrating lawmakers, who have sought that the VA consider alternatives to the Cerner-Oracle EHR system.

Bost said at a hearing last July that an independent cost analysis from the Institute for Defense Analyses found new Oracle-Cerner EHR system will now cost $39 billion to implement over 13 years, and $17 billion to maintain over the next 15 years. The EHR migration is currently expected to cost $16 billion over 10 years.

“What the VA is getting today would be a bad investment at any price,” Bost said.

Rosendale said the VA’s legacy EHR system, VistA, still works, and would be much less expensive to maintain than to continue the migration to the Oracle-Cerner EHR.

“The responsible thing to do is to stop throwing money at Oracle-Cerner and make targeted investments to shore up VistA,” Rosendale said.

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