VA Extends Pause on Rollout of Oracle Cerner EHRM Project

The Department of Veterans Affairs (VA) has extended the pause on its EHR modernization (EHRM) project rollout, according to reporting from Federal News Network.

Laura Ruzick, director of Veterans Integrated Services Network (VISN) 10, told staff in a memo that recent assessments show the Oracle Cerner EHR is "not yet ready for the planned June deployment" in Saginaw, Michigan.

"As VA leadership has promised, we will not deploy the new EHR system at any facility until we are confident it is ready to deliver for veterans and VA providers," Ruzick noted.

She told staff that VA has postponed EHR training scheduled for April 11 and that the VISN will have updates in the coming weeks.

"I know your commitment to this project has been and will continue to be extraordinary, and I am personally grateful to each one of you for your dedication," Ruzick wrote. "I am confident that when we do roll out the new EHR system in Saginaw, we will make it a smooth, safe, and positive experience for veterans and staff alike — and we will do so together."

The VA is looking to renegotiate the terms of its contract with EHR vendor Oracle Cerner.

Denis McDonough, VA secretary, told House appropriators last week that the agency has yet to finalize its go-live decision for Saginaw.

"That's a decision we've not yet made," he said. "We'll make that [decision] based on where the technology is. But to be honest with you, increasingly, my question is, I need to see what happens in this contract before we make a decision about where we go next anyway, because the contract may not be what we need."

VA also recently pushed off the EHR go-live in Ann Arbor, Michigan, from July 2022 to late 2023 or early 2024. In February, Shereef Elnahal, VA undersecretary for health, told reporters that the Ann Arbor postponement is related "directly to functionality within Cerner around clinical research."

Further, VA officials informed the Senate committee staff of six "catastrophic harm" incidents, including four veteran deaths, linked to patient safety issues with the EHRM in a recent briefing on March 15, 2023.

House VA Committee Chairman Mike Bost (R-Ill.) and Technology Modernization Subcommittee Chairman Matt Rosendale (R-Mont.) said in a statement that the EHR pause "should last as long as it takes for VA and Oracle-Cerner to get their houses in order."

"That may be years, but the delivery of good care and services to veterans depends on it," they said.

Bost and Rosendale added that it "is abundantly clear to us that the Oracle Cerner EHR system is not ready for prime time, and VA is not ready to carry out this project."

VA now faces four legislative efforts in Congress that, if passed, would ramp up standards for the EHR modernization project.

Senate VA Committee Ranking Member Jerry Moran (R-Kan.) introduced one of the most recent EHR reform bills with 11 colleagues. The VA EHR Modernization Standardization and Accountability Act would require VA to demonstrate that its new EHR meets performance metrics at the five sites already using it before deployment to additional medical centers.

Jon Tester (D-Mont.), Senate VA committee chairman, and Sens. Patty Murray (D-Wash.) and Sherrod Brown (D-Ohio) introduced a similar bill called The EHR Program RESET Act.

The bill would prevent VA from additional EHR go-lives until data from the five sites using the system "demonstrate an ability to deliver healthcare to veterans at standards that surpass metrics" using VA's legacy VistA EHR.

The RESET Act would also require VA to create a "plan B" for the Oracle Cerner EHR if the vendor doesn't agree to new contract terms that "increase accountability and penalties for poor performance."

In February, top Republicans on the House VA Committee introduced the VA Electronic Health Record Modernization Improvement Act, which would require "significant improvements" from the EHR before further implementation at VA care settings.

An additional bill, led by Bost and Technology Modernization Subcommittee Chairman Matt Rosendale (R-Mont.), would force VA to pull the plug on the Oracle Cerner EHR.

Top Democrats on the House Veteran Affairs Committee, meanwhile, have introduced bills that broadly target the VA's IT and acquisition projects.

The Manage VA Act would require the VA to create an undersecretary for management position to oversee IT and acquisition decisions.

The VA IT Modernization Improvement Act would require VA to hire a third-party auditor to oversee the rollout of major IT programs.

Mark Takano (D-Calif.), House VA committee ranking member, and Sheila Cherfilus-McCormick (D-Fla.), technology modernization subcommittee ranking member, introduced the bills.