Lawmakers have made it clear that the Department of Veterans Affairs' $16 billion electronic health records project would be under close scrutiny. This week, two senators took steps to ramp up that oversight of the beleaguered IT initiative.
U.S. Senators Jon Tester, D-Montana, and Marsha Blackburn, R-Tennessee, introduced this week bipartisan legislation (PDF) to establish a third-party oversight committee to help monitor the implementation of the new EHR system.
The 11-member EHR advisory committee would be made up of medical professionals, IT and interoperability specialists and veterans currently receiving care from the VA but would operate separately from the departments of Veterans Affairs and Defense, according to a press release.
The VA signed a $10 billion deal with Cerner last May 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 begun integrating Cerner’s MHS Genesis system.
"The new electronic health record system is too important to veterans' health care for the VA to get wrong," Tester, the ranking member of the Senate Veterans' Affairs Committee, said in a statement. "Our bill will create another layer of accountability and oversight of the process to make sure the VA roll-out does right by the 9 million veterans who will rely on this system."
Blackburn said that a crucial part of giving veterans better care is improving the way the DOD and the VA organize their health records.
"The EHR Advisory Committee will be entirely devoted to ensuring the implementation and transition is done as smoothly as possible. Comprised of professionals who have experience in the health care field, as well as veterans currently receiving care at the VA, this committee will have the knowledge and expertise to increase the effectiveness and efficiency of the VA's services," she said.
The committee will be tasked with analyzing the VA's strategy for implementation, developing a risk management plan, touring VA facilities as they transition to the new system and ensuring veterans, VA employees and medical staff and other participants have a voice in the process.
The committee also will meet with the VA secretary at least twice a year on their analysis and recommendations for implementation.
Tester and Blackburn said the EHR advisory committee is necessary to help keep the VA on target and transparent on its rollout of the new multibillion-dollar commercial EHR system for 9 million veterans.
The VA plans to pilot initial operating capabilities of its new Cerner EHR platform in March 2020 across three sites in the Pacific Northwest.
The VA has faced regular hiccups in its development of an EHR system, as revealed in numerous watchdog reports and during congressional hearings.
Lawmakers in both houses of Congress have made it clear that they continue to have concerns about the cost and timeline of the project, as well as ensuring seamless interoperability between the VA and DOD systems and with private sector healthcare providers.
The Government Accountability Office has examined the VA’s system modernization efforts and found that the department has significant challenges in managing its IT projects and programs. At a recent hearing, a GAO official said the VA's EHR project already is facing serious challenges and the ability of the VA and the DOD to hash out differences between their EHRs would be crucial to the success of the projects.
The VA's EHR project also has been plagued by gaps in leadership. The VA announced an oversight entity, the Office of Electronic Health Record Modernization, back in July. Genevieve Morris, formerly principal deputy national coordinator for health IT at ONC, was tapped for that post, but she resigned two months later. She cited her resignation to differences in opinion over where the project should be heading.
The VA has had high turnover in its CIO role, with 10 CIOs since 2004 and six since 2012, according to the GAO.
At one point, a top lawmaker tasked with overseeing the VA's EHR effort, Rep. Jim Banks, R-Indiana, called out the agency's "deteriorating and rudderless" leadership in the wake of two key departures.
In addition, a Politico article last year detailed major failures in the Pentagon's $4.3 billion Cerner EHR implementation. Military and VA health IT specialists and doctors reported that technical glitches and poor training caused dangerous errors and reduced the number of patients who could be treated, according to that article. Lawmakers have also scrutinized the VA's IT initiatives to support its Community Care initiative following a highly critical report from the U.S. Digital Service about a flawed software tool the VA is building.