Senate Democrats join calls for pause on new VA EHR rollouts until metrics improve

Top Democrats on the Senate Veterans Affairs Committee are introducing legislation that would pause the VA’s troubled rollout of a new Electronic Health Record (EHR) until sites already using the system show improvement.

The EHR Program RESET Act, led by Committee Chairman Jon Tester (D-Mont.) and Sens. Patty Murray (D-Wash.) and Sherrod Brown (D-Ohio), would prevent the VA from proceeding with EHR go-lives at additional facilities, until data from the five current sites using the system “demonstrates an ability to deliver health care to veterans at standards that surpass metrics” using VA’s 40-year old legacy VistA EHR. 

The RESET Act would also require the VA to come up with “an alternative ‘Plan B’ strategy” for the Oracle-Cerner EHR, if the vendor doesn’t agree to new contract terms that “increase accountability and penalties for poor performance,” or if the agency can’t get the EHR to “serve veterans efficiently and safely.”

The upcoming Senate bill is the third legislative effort in recent months scrutinizing VA’s troubled EHR rollout. Top Republicans and Democrats on the House VA Committee have also introduced their own bills that would set a higher bar for the Oracle-Cerner EHR’s performance.

Bipartisan frustration over the EHR rollout escalated earlier this month, when SVAC members said the VA recently notified them of six “catastrophic events” related to a feature of the EHR modernization program over the last couple of years. Senators said that four of the catastrophic events resulted in fatalities.

Tester said at a recent committee hearing that Oracle-Cerner has refunded VA about $325,000 of the $4.4 billion paid through the contract so far. He urged VA and Oracle-Cerner executives to renegotiate the multi-billion contract by the time their current agreement expires in May.

Tester said in a statement Wednesday that too many veterans and VA employees have “faced confusion and unnecessary problems because of VA’s Electronic Health Record rollout.”

“VA needs a reset, and must meet specific metrics on patient safety, cost, and VA employee productivity to improve morale and improve veterans’ experiences when they turn to the VA for care,” Tester said.

VA Secretary Denis McDonough told House appropriators on Wednesday that the Oracle-Cerner EHR rollout to date has been “no question a disservice” to veterans.

“We remain committed to the idea. We’ve got to get the contract right. We’ve got to get the execution right,” McDonough told the House Appropriations Committee’s subcommittee on military construction, VA and related agencies.

The VA medical center in Saginaw, Michigan is currently scheduled to be the first new go-live of the multibillion-dollar Oracle-Cerner EHR since the VA paused rollouts last October. But McDonough told the House subcommittee the VA has not yet finalized that decision.

“That’s a decision we’ve not yet made.  We’ll make that [decision] based on where the technology is. But to be honest with you —increasingly, my question is, 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,” McDonough said.

The VA recently released its EHR Modernization Sprint Report, which identifies four key issues leading to problems with the Oracle-Cerner rollout, as well as 14 issues with the system that need to be fixed.

The “Plan B” language in EHR Program RESET Act echoes a similar two-track proposal introduced by House VA Committee Republicans.

The VA Electronic Health Record Modernization Improvement Act 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.

Rosendale also introduced a separate bill that would force the VA to completely pull the plug on the Oracle-Cerner EHR. Bost is a cosponsor of the bill.

A spokeswoman for the House VA Committee previously told Federal News Network 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.”

Top Democrats on the House Veteran Affairs Committee, meanwhile, have introduced bills that more broadly target the VA’s largest IT and acquisition projects.

The Manage VA Act would require the VA to create an Under Secretary for Management position to oversee its IT and acquisition decisions.

The VA IT Modernization Improvement Act would require the VA to hire a contractor to provide a third-party assessment of its major IT programs.

The third-party auditor would oversee the rollout of VA’s Oracle-Cerner Electronic Health Record, as well as its Veterans Benefits Management System, Financial Management Business Transformation and supply chain modernization efforts.

Committee Ranking Member Mark Takano (D-Calif.) and Technology Modernization Subcommittee Ranking Member Sheila Cherfilus-McCormick (D-Fla.) introduced the bills.

Takano said in a March 22 statement that he hopes the bills lead to the “beginning of a bigger discussion about making VA work better for veterans and moving VA healthcare into the future.”

The upcoming RESET Act would also require the Department of Defense to give Congress quarterly updates on steps it’s taking to fix DoD IT systems, “including those which are outdated and are negatively impacting VA’s ability to deliver health care, benefits, and other services, including through the new EHR.”

DoD and the Coast Guard’s deployment of the same Oracle-Cerner EHR system adopted by VA is 75% complete.

Mike Sicilia, executive vice president for industries at Oracle, recently said DoD will complete its deployment of the Oracle-Cerner EHR by the end of the year “on time and on budget.”

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