VA hits pause on future rollouts of EHR until 2023 while lawmakers raise fresh concerns about patient safety risks

The Department of Veterans Affairs (VA) will push off deployment of a new electronic medical records system to additional medical facilities until 2023 to address outages that have plagued the software at current sites.

The VA acknowledged in a statement that there have been "unanticipated outages and system degradations" from the onset of the new Oracle Cerner electronic medical record system rollout. The EHR system has been rolled out to three VA facilities to date.

The VA had planned to deploy the new health records software, which was developed by Cerner, now owned by Oracle, at the Puget Sound VA Health Care System, including American Lake and Seattle VA Medical Centers, this August, but will now push that project to March 2023 instead, a VA spokesperson confirmed.

Plans to deploy the platform to the VA Portland Health Care System at the Portland and Portland-Vancouver VA Medical Centers has been delayed from this November to April 2023.

"VA has consistently communicated that it will review each site’s readiness for deployment to ensure a successful and safe transition to the new EHR," the VA spokesperson said.

Lawmakers were informed of the delay Friday night, according to the Federal Times.

The VA will continue with plans to deploy the software at VA sites in Boise, Idaho, next month, officials said.

On Sunday, The Spokesman-Review reported that a draft VA Office of Inspector General report has flagged serious patient safety risks with the new system.

According to reporting from The Spokesman-Review, which obtained a copy of the watchdog report from multiple sources, the computer system at Spokane’s VA hospital has caused harm to at least 148 veterans in the inland northwest.

The draft report shows a VA patient safety team briefed the department’s deputy secretary in October 2021 about the harm and ongoing risks. Despite those warnings, the VA has since launched the system at more facilities in Washington, Idaho, Oregon and Ohio, The Spokesman-Review reported Sunday.

In response to those media reports, House Committee on Veterans’ Affairs Chairman Mark Takano, D-California, and HVAC Subcommittee on Technology Modernization Chairman Frank Mrvan, D-Indiana, said the draft findings are "seriously troubling and contradict what we have heard from VA officials during public testimony."

Takano and Mrvan requested an official briefing on the forthcoming report. "Once released, we will be reviewing the findings closely in order to determine if there are any contractual or legal repercussions of these draft findings," they said in the statement issued Wednesday.

Oracle plans to bring "substantially more resources" to the project

The move to adjust the rollout schedule comes amid growing concerns from Congress about ongoing problems with the implementation of the software platform.

"In evaluating Puget Sound’s and Portland’s readiness for deployment, VA determined the system hadn’t shown adequate reliability to support the current schedule. The date was changed to allow Oracle Cerner to put important system enhancements in place and make the necessary improvements to ensure system stability, securing the 99.9% uptime Service Level Agreement (SLA) currently contracted, as well as fix outstanding issues to address research workflow challenges," the VA spokesperson said.

Oracle acquired health IT giant Cerner just two weeks ago.

Deborah Hellinger, vice president of global corporate communications at Oracle, said in a statement that Oracle engineers have already been on the ground making technical and operational changes, "with an emphasis on patient safety, to ensure the system exceeds the expectations of providers, patients, and the VA."

"We intend to bring substantially more resources to this program and deliver a modern, state-of-the-art electronic health system that will make the VA the industry standard. We have a contractual and moral obligation to deliver the best technology possible for our nation’s veterans, and we intend to do so," Hellinger said in the statement.

Lawmakers have moved to step up oversight of the VA's EHR project. Under new legislation headed to President Joe Biden's desk, the VA will be required to submit regular reports to Congress about the performance of its new $16 billion medical records system, including incidents that risk patient safety.

The new EHR system, developed by Cerner, now owned by Oracle, was first rolled out to Mann-Grandstaff VA Medical Center in Spokane, Washington, in November 2020, following two monthslong delays to address the department's information technology infrastructure and training and respond to the COVID-19 pandemic.

The EHR system then was brought online at a VA hospital in Walla Walla, Washington, and Columbus, Ohio, earlier this year.

The Cerner system replaces software that’s more than 30 years old, and the aim is to align the country’s largest health system with the Department of Defense, which has already started integrating Cerner’s MHS Genesis system.

The VA signed a $10 billion deal with Cerner in May 2018 to move from the VA’s customized VistA platform to an off-the-shelf EHR. The cost of the project has since ballooned to $16 billion.

In May, VA Secretary Denis McDonough told the House VA Committee that he's “very concerned about execution of the program to date,” but will press ahead with the EHR rollout, Federal News Network reported.

McDonough said the new EHR from Cerner has experienced five shutdowns since March 3, the first of which was so “egregious” that the company’s CEO issued a signed apology, the media outlet reported.

In order to ensure the system is reliable, technicians must regularly test and validate system resiliency, the VA spokesperson told Fierce Healthcare in a statement.

"VA is requesting that Oracle Cerner develop an execution plan to put this regular testing and confirmation of resiliency in place," officials said.

The revised deployment schedule will enable Oracle Cerner to address these potential gaps in system reliability, particularly in the more complex sites that are upcoming, such as Puget Sound and Portland, according to the VA.

"Between major deployments VA will continue to work vigorously to ensure that the system has the capability enhancements and is optimized to support deployment at Level IA facilities and VA’s ambitious deployment schedule in 2023," the VA spokesperson said.