The Department of Veterans Affairs' achieved a major milestone Saturday in its decadeslong, multibillion-dollar effort to upgrade its aging health IT systems.
Mann-Grandstaff VA Medical Center in Spokane, Washington, went live with a new Cerner EHR system this weekend, the first site as part of VA's massive medical records project.
It marks progress in the latest effort to upgrade the VA's system, a $16 billion technology project that's been plagued by delays, leadership turnover, and infrastructure problems since it kicked off in 2018.
According to Mann-Grandstaff officials, the transition to Cerner's EHR means veterans receiving care at the facility and at its outpatient clinics will use the new My VA Health online portal to schedule, review and cancel health appointments, refill their prescriptions, send secure messages to their VA providers, and manage their current health records.
The VA twice-delayed the initial roll-out of the Cerner EHR at the Spokane facility. The VA decided in mid-February to push off its go-live date for the new EHR at its first VA hospital.
The VA had planned to flip the switch on the new EHR at Mann-Grandstaff VA Medical Center in Spokane, Washington on March 28. The VA then said it was delaying those plans to commence end-user training.
In early April, the VA hit pause against on its $16 billion electronic health record overhaul due to the COVID-19 pandemic. The department restarted the project in August.
The pandemic delays bought VA valuable time to improve the EHR, even if the department won’t launch with a full suite of capabilities all at once. It plans to deploy a second of two capability sets in Spokane next spring, Federal News Network reported, citing Laura Kroupa, chief medical officer for VA’s Office of Electronic Health Record Modernization.
“We worked on interfaces. We worked on improving our training posture,” Kroupa said last week during Cerner’s 2020 virtual summit, Federal News Network reported.
In a statement issued Friday, House Veterans Affairs Technology Modernization Subcommittee Ranking Member Jim Banks, R-Indiana, said he was “cautiously optimistic” the go-live would be a success.
"Tomorrow’s initial go-live is the beginning of a long journey, and in all likelihood, the challenges will become more numerous moving forward," Banks said. "I am committed to rigorous oversight, transparency, and accountability to the public every step of the way."
Banks added, "This effort is about much more than new software. It represents the opportunity for veterans and service members to control their own health information and health care decisions, and it offers the potential for VA and DoD not just to keep pace with the marketplace but lead innovation in the whole health care sector.”
House Veterans Affairs Committee Ranking Member Phil Roe, R-Tennessee, praised the go-live at Spokane, noting that it marked “real progress" in the VA's EHR project.
"I know from personal experience that any electronic health records implementation is difficult and disruptive, even in a single medical practice, and the VA health care system stands alone in its size and complexity," he said.
Government watchdogs and Congressional leaders continue to have concerns about the project including infrastructure issues and leadership challenges.
A VA inspector general report released in April found that VA medical centers require significant upgrades to physical and information technology infrastructure in preparation for the EHR implementation.
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.
In preparation for the go-live in Spokane, the VA in October transferred clinical and demographic data for approximately 88,000 veterans into the new EHR system, which provides doctors with a longitudinal view of patient information, VA officials said.
In August, the department launched its new patient appointment system at sites in the VA Central Ohio Healthcare System. In April, VA and the DOD unveiled a joint health information exchange to enable medical providers at both agencies to share patient data with each other and with private sector healthcare organizations.
The VA's electronic health record modernization program will continue over the next several years. The agency plans to have the software in place nationwide at all VA facilities by 2028. The VA operates 170 hospitals and also provides care at 1,074 outpatient sites.