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House representative proposes bills to amend or permanently end VA EHR project

por John R. Fischer, Senior Reporter | February 07, 2023
Health IT
Two bills are calling to amend or permanently end the VA EHR project.
Representative Mike Bost (R.-Illinois) has introduced two bills to the House floor that, if passed, would substantially amend or entirely end all installations of the Department of Veterans Affairs’ Oracle Cerner electronic health record system.

Purchased in 2016 by the VA, the Cerner Millennium system was rolled out in 2020 but has experienced several technical issues that have led to training failures, shutdowns, data migration problems and patient safety concerns, as well as underestimated infrastructure costs.

The Department of Veterans Affairs’ Electronic Health Record Modernization Improvement Act, introduced on January 26, would prevent the VA’s from installing the EHR at more locations without sign-off from senior clinicians, according to FedScoop.

A complementary bill introduced by Bost and Rep. Matt Rosendale (R.-Montana), To terminate the Electronic Health Record Modernization Program of the Department of Veterans Affairs, would scrap the whole project.

“It has crippled the delivery of care, put veteran patient safety at risk, and stressed an already overwhelmed healthcare system," said Bost.

Under the first bill, the director, chief of staff and network director at every VA medical center would need to certify that the EHR is correctly configured and that staffing levels and infrastructure can support it prior to deployment. Frontline medical leaders would also need to certify that it would not adversely affect safety, quality or current wait times.

The VA and Oracle Cerner would not be able to commence go-live preparations at further sites until the agency secretary certifies that the EHR facilitated 99.9% uptime and that technical repairs were complete.

In a statement, Oracle executive vice president Ken Glueck said switching from "customized, one-off workflows to standard, commercial-off-the-shelf workflows is always hard" but "always worth doing," and that an endeavor "of this scale and scope" requires time to dismantle "decades of customized processes" used to support the previous EHR system used by the VA.

The VA halted further implementation of the platform in 2022 following "unanticipated outages and system degradations" to address potential gaps. The VA confirmed in May 2022 that the system had gone down more than 50 times since its launch.

In October, it said ongoing issues may have affected care for nearly 42,000 veterans, including delays in appointments, tests results, referrals and medication.

All locations currently using the system, including Department of Defense and the Coast Guard sites, experienced another major slowdown and connectivity issues in January, reported FedScoop.

And a recent survey by healthcare IT research firm KLAS Research showed that 78% of Oracle Cerner EHR users at the VA disagreed or strongly disagreed that the system facilitates high-quality care delivery.

“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. That’s exactly what our bill would do,” said Bost.

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