VA Cerner EHR Implementation Paused Through 2021 to Ensure Readiness

The Department of Veterans Affairs’ (VA) announced that it has paused its EHR implementation through the end of this calendar year as it works to ensure enterprise readiness at the next go-live.

This comes after a recent report from the Office of the Inspector General (OIG) revealed that VA officials’ underestimated the projections for the Electronic Health Record Modernization (EHRM) project by $2.5 billion. A seperate OIG review found issues regarding EHR training at the project’s pilot site, Mann-Grandstaff VA Medical Center in Spokane, Washington.

At a House hearing on Wednesday, Carolyn Clancy, MD, VA undersecretary, addressed the EHR rollout’s shortcomings and discussed next steps for the EHRM project.

Clancy explained the VA will pursue technical-only deployments of Cerner health IT at previously planned sites in Veterans Integrated Service Networks (VISNs) 10 and 20. This will allow the VA to ensure enterprise readiness without interfering with veterans’ care or frontline employees’ clinical workflows.

Clancy noted that the agency will also accelerate technical infrastructure upgrades for the EHR implementation. Additionally, Clancy said the VA will establish a test and training environment to evaluate system functionality.

“This will enable us to evolve our processes, training, and change management – and test our approach to build evidence-based confidence in the success of our next deployment before we ‘go-live’ again,” she said in hearing testimony.

Clancy said that the VA will conduct technical and qualitative reviews of all facilities which were previously planned to be completed over the life of the 10-year project to help establish an evidence-based view of enterprise site readiness.

“This new approach will result in a shift from sequential site engagements over the next decade, to integrated enterprise readiness and planning,” she said.

The VA will invest in training and change management capabilities to ensure the workforce is prepared for the EHR implementation at their individual locations, Clancy noted. Additionally, the agency will improve its organizational structure and governance to “become more responsive and effective.”

“We are taking swift and decisive action to incorporate the management rigor and enterprise jointness required for this program to deliver on its intended purpose: seamless excellence in VA care for Veterans,” Clancy said. “You will see us pursue a surge of activity in the coming weeks and months, intently focused on Veteran experience, patient safety and employee engagement.”

Brian Sandager, general manager of Cerner's government business, noted that the EHR vendor is working with the VA to quickly improve patient safety and end-user satisfaction at the pilot site.

“Since go-live, nearly 800 changes have been implemented,” Sandager said during the hearing. “These changes include significant progress and improvements to training, simplifying workflow design and alerts, and reducing the time providers are spending in the system — ultimately improving the delivery of care and overall provider experience.”

“Our Cerner associates are committed to working quickly and effectively to identify meaningful requirements that meet the needs of our nation’s Veterans, while enabling us to continue deployment of the new system and ensuring improved end-user adoption and patient safety,” Sandager continued.

Lawmakers on both sides expressed frustration about the inaccurate spending estimates.

At the hearing, ranking Member Mike Bost (R-IL), Frank Mrvan, (D-Ind), and Mark Takano, (D-Calif) introduced the bipartisan VA Electronic Health Record Transparency Act to improve cost transparency for the EHRM project.

“As I have said from the start, VA must be crystal clear on the true cost of the Electronic Health Record Modernization program for the veterans and taxpayers they serve,” Bost said in a statement on his website. “Right now, the effort is stumbling. The time has come to look at every dollar going out the door. I am introducing the VA Electronic Health Record Transparency Act to increase oversight and do exactly that.”