Lawmakers move to block VA’s plans to resume health records rollout

Plans from Veterans Affairs leadership to restart their embattled electronic health records program this summer could be upended by lawmakers concerned over the long-term safety and reliability of the program.

Capitol Hill staff said members in both chambers are discussing how to move ahead on new requirements for the program after a flurry of new legislation aimed at ensuring the new records system doesn’t move ahead until major fixes are made. If a compromise is reached, it could significantly set back plans from VA officials to expand the software to new medical centers in June.

Last week, Republicans led by Senate Veterans’ Affairs Committee ranking member Sen. Jerry Moran, R-Kan., introduced the latest piece of legislation on the matter, proposing delays to future work on the records modernization program until certain performance benchmarks are met.

Moran called progress on the work so far “troubling” and noted that “without these changes, it would be irresponsible to continue implementing the system at additional VA centers.”

The bill came just a few days before Senate Democrats led by Committee Chairman Jon Tester, D-Mont., introduced similar requirements for major reforms to the program. That list includes certifying that existing sites using the new software are meeting acceptable medical care standards, and assurances that recurring problems with the records system are sorted out well before new staffers are assigned to work on it.

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“It’s clear that the new electronic health records system is failing veterans, medical personnel, and taxpayers,” Tester said in a statement. “We need aggressive measures to right this ship and get a better return on investment through this contract.”

The details of two Senate measures differ in specifics from a bill introduced by House Republican leaders (including House Veterans’ Affairs Committee Chairman Mike Bost, R-Ill.) in January, but the message behind all of the legislation is the same: Lawmakers lack confidence in the 10-year, $16-billion records overhaul.

Ant more delays to the program’s schedule would call into question whether the project could be finished under its original timeline or original cost estimate. The records overhaul was launched by President Donald Trump in 2017 as a way for the first time to bring veterans’ health records in line with military files.

In the past, the two agencies used separate records systems with intermediary programs to transfer data between them, causing information issues for patients and physicians. The new system, designed by Oracle Cerner, would in theory provide a lifelong health record for individuals from military enlistment through their time with VA health care.

Installation of the new Defense Department records system (which began a few years before the VA launch) has largely remained on schedule. But numerous problems with the VA system at the first few sites prompted several delays, including a full shut-down of the rollout plan last fall.

Issues included an inspector general report which found at least 148 cases of patient harm caused by record entry mistakes; more than 11,000 orders for specialty care and lab work lost in the new system; and six patient deaths since last fall where the new system was “one of a potential number of root causes,” according to the department’s top health official.

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Leadership from both VA and Oracle Cerner in recent months have said that those problems have been fixed. The software vendor has also stated publicly that system reliability has significantly improved since last fall, although VA officials have not backed up that statement.

Still, VA Secretary Denis McDonough in an appearance before the House Appropriations Committee last week said officials believe they are headed towards resuming site deployments this summer, barring any additional setbacks. The department is in mid-contract negotiations with Oracle Cerner now on program metrics and costs, expected to be finalized later this spring.

“We remain committed to the idea,” he told lawmakers. “We’ve got to get the contract right. We got to get the execution right.”

Of VA’s more than 170 medical center sites, five are currently using the new Oracle Cerner health records system: Mann-Granstaff VA Medical Center in Spokane, Wash.; Jonathan M. Wainwright VA Medical Center in Walla Walla, Wash.; the VA Central Ohio Healthcare System in Columbus, Ohio; the Roseburg VA Health Care System in Roseburg, Ore.; and the VA Southern Oregon Rehabilitation Center and Clinics in White City, Ore.

The VA Saginaw Healthcare System in Michigan is slated to be the next site to receive the health records update, although officials have said that could change based on safety and training concerns.

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