VA Announces New Plan, Roles for EHR Implementation Program

VA has created two new executive roles that are set to enhance program management and coordination for its systemwide EHR implementation.

The Department of Veterans Affairs (VA) has updated its EHR implementation plan to address challenges revealed in this year’s Electronic Health Record Modernization (EHRM) program strategic review.

The new plan includes a revised rollout schedule, two new executive roles, and what the agency said is a significantly strengthened Office of the Functional Champion (OFC).

“We will do everything we can to get electronic health records right for Veterans and our healthcare staff, with patient safety being the key driver and nonnegotiable,” VA Deputy Secretary Donald M. Remy said in a press release.

“I have incorporated the lessons learned I received during my recent meetings with our team at Mann-Grandstaff VA Medical Center in Spokane, Washington, into this new way forward,” Remy added.

VA developed a revised schedule for the EHR system rollout to early fiscal year 2024. Pre-deployment activities are underway in VISNs 10 and 20 while preparing for future fiscal year site deployments in VISNs 12 and 23. VISN 12 includes the joint VA-DOD site in North Chicago, where coordination activities have begun.

“Future deployments, adjustments, and/or modifications to the schedule will be made based on any additional clinical and technical findings and will continuously consider the effects of the ongoing COVID-19 pandemic,” VA officials noted.

The new EHR management structure is based on a revised change management approach that incorporates best practices in customer experience, communication, risk management, business process, system development, and lifecycle management, the VA said.

The critical changes in EHRM management include the establishment of:

  • A Program Executive Director (PED) for EHR Integration
  • A significantly strengthened OFC
  • A Deputy Chief Information Officer (DCIO) for EHR

The PED, a new position, will report directly to the VA Deputy Secretary and will have operational control over the offices of Functional Champion, Technical Integration, and Program Management.

The VA Secretary selected Terry Adirim, MD, MPH, MBA, to be the PED. Adirim is the Principal Deputy Assistant Secretary of Defense and is currently serving as the Acting Assistant Secretary of Defense for Health Affairs.

The strategic review also identified a need for greater clarity of responsibilities within the EHR implementation program’s governance structure to support stakeholder input and timely decision making.

As a result, VA is establishing a new EHR Integration Council. The council, chaired by the PED, will ensure decisions are coordinated and timely while addressing the need for an operational decision layer at the enterprise level, VA said.

The strengthened OFC will help bridge any divides among IT, the EHR vendor, and care delivery teams to ensure the needs of the practicing clinicians and support staff are met, VA added. The revamped OFC will also play a principal role in processing and resolving patient safety concerns.

The DCIO, another new position, will assume all technology integration functions for the EHR implementation to ensure close communication with technical staff at local sites, VA said.

“Under my direction, VA is refining EHR governance and management structures to establish additional rigor and oversight,” Remy said. “VA, in coordination with our partners, the Department of Defense and EHR vendor Cerner, will continue to update and refine the EHR implementation process to ensure it delivers the excellence Veterans expect and deserve from VA.”

Brian Sandager, general manager and senior vice president of Cerner Government Services told EHRIntelligence in an emailed statement that Cerner has and will maintain onsite support at Mann-Grandstaff.

"We remain committed to Secretary McDonough, the providers and staff, and Veterans," Sandager said. "Cerner will continue partnering with VA to gain access to the site, ensuring the program continues to move forward successfully. Cerner shares VA's sentiment that the new governance and leadership will positively impact the program. We are on a path to deliver world class healthcare for our nation’s Veterans and look forward to advancing our partnership and additional deployments in 2022." 

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