Lawmakers irked at lack of transparency from VA after Cerner EHR project delay

Veterans affairs sign
Lawmakers on both sides of the aisle want more answers on why the department pushed off its go-live date for the multi-billion dollar medical records system. (JeffOnWire CC BY 2.0)

Congressional Democrats said they felt blindsided by the Department of Veterans Affairs' (VA's) decision this week to push off its go-live date for a new $16 billion medical records system.

The House Veterans' Affairs Subcommittee on Technology Modernization plans to hold a hearing in the next few weeks to scrutinize the VA's decision to delay the platform's rollout, Susie Lee, D-Nevada, chairwoman of the subcommittee, announced.

The VA had planned to flip the switch on the new electronic health record (EHR) at its first site—Mann-Grandstaff VA Medical Center in Spokane, Washington—on March 28. But the VA announced this week it's delaying plans to commence end-user training, which may impact “going live” with its EHR in March in Washington.

"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," VA spokesperson Christina Mandreucci told FierceHealthcare in an emailed statement.

"We believe we are 75-80% complete in this regard and will be announcing a revised 'go-live' schedule in the coming weeks," she said.

RELATED: (Another) roadblock identified in VA, DOD transition to Cerner EHR

Lee said during a hearing on VA's data privacy policies Wednesday that the VA needs to be "forthright about its progress, identify concerns, and notify Congress about any challenges."

"I’ve long said that getting it right is far more important than hitting a date on a calendar. If there needs to be a delay to get the system to a place where veterans' lives are not at risk and VA staff are ready to use it, that’s the right thing to do," she said.

She added, "However, I’m concerned that as we have moved closer to the go-live date, we were told repeatedly there were no show-stoppers in implementation, that testing was going great, and that things were on track."

Politico reported that the committee's staff said the VA had not mentioned the possibility of delay in recent meetings. When the department informed Lee of the decision, VA officials employed inconsistent explanations, committee staff told Politico.

Lee acknowledged that software development and testing conditions can change rapidly, but the committee requires "transparency and for the VA to be accountable for its actions." 

She also noted that President Donald Trump's proposed budget would "speed up" the EHR project rollout.

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 to align the country’s largest health system with the Department of Defense, which has already started integrating Cerner’s MHS Genesis system.

For the VA, the Cerner EHR will replace the approximately 130 operational instances of VistA currently in use across the department. While the initial EHR contract signed with Cerner was for $10 billion, the VA has pushed the estimated 10-year cost for implementing the system past $16 billion.

RELATED: Lawmakers fear lack of governance of DOD-VA EHR project will derail progress

The VA's delay comes a week after a key VA EHR project leader, former VA Deputy Secretary James Byrne, was abruptly dismissed. In his five months at the agency, Byrne was a key leader updating members of Congress on the progress and challenges of the implementation.

Lawmakers on both sides of the aisle want more answers on why the department pushed off its go-live date for the multibillion dollar medical records system.

Rep. Jim Banks, R-Indiana, ranking member of the committee, said during the hearing that he supported VA Secretary Robert Wilkie's decision to delay the EHR launch but was disappointed that no VA officials in charge of the EHR project attended Wednesday's hearing, as lawmakers had requested.

Rep. Phil Roe, M.D., R-Tennessee, the ranking member of the House Committee on Veterans’ Affairs and a member of the subcommittee, said VA's decision to delay the project highlighted the need for lawmakers to ramp up oversight of the project.

Sen. Jon Tester, the ranking member of the Senate Veterans’ Affairs Committee, said in a statement that, “VA must establish stable leadership to provide sufficient accountability and robust oversight of this process.”

Mark Takano, D-California, chairman of the House Veterans' Affairs Subcommittee on Technology Modernization, said he supported VA leadership taking the time they need to get the $16 billion dollar implementation right, but leaders need to be transparent with Congress.

During Wednesday's hearing, Paul Cunningham, the VA's deputy assistant secretary and chief information security officer, testified that he was made aware of the EHR project delay on Tuesday.

The delay was more a "tactical decision" than a result of a lack of resources, he said, while acknowledging that the project was "outside his purview."

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