VA Extends Delay of EHR Deployments Until June 2023
The Department of Veterans Affairs has extended the delay of deployments of the Oracle Cerner electronic health record (EHR) until June 2023 to address challenges with the system and make sure it is functioning optimally for veterans and for VA healthcare personnel.
This decision comes after Secretary Denis McDonough announced in July that VA would delay EHR deployments until January 2023 to ensure that the system’s issues had been resolved. During VA’s subsequent investigation at its current sites, several additional technical and system issues were identified – including challenges with performance, such as latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders.
The Oracle Cerner EHR is replacing VA’s current Veterans Health Information Systems and Technology Architecture (VistA). VA previously reported that this effort will cost about $16 billion—but, as of December 2021, VA was re-evaluating its cost. It is expected to take about 10 years to implement the new system across VA facilities nationwide. As of October 2021, completion was projected for fiscal year 2028.
Earlier this year, a U.S. Department of Veterans Affairs Office of Inspector General (OIG) report found that more than a year after go-live with the new EHR at Mann-Grandstaff VA Medical Center, gaps in available metrics due to the EHR transition impaired the facility’s ability to measure and act on issues of organizational performance and patient safety.
Spokane, Washington-based Mann-Grandstaff was the first Veterans Health Administration (VHA) medical center to implement the new EHR system.
The OIG determined that, one year after go-live, gaps existed between required metrics and those that were available using new EHR data. These gaps impeded assessment and action to address organizational performance, quality and patient safety, and access to care at the facility.
According to the June 1 report, the OIG found that following go-live, facility staff used workarounds to mitigate the post go-live metrics gap. Facility staff shared with the OIG that the workarounds created a “tremendous” increase in additional workload, at times requiring numerous hours or days to prepare just one metrics report. Despite time-intensive workarounds and concerns with metrics accuracy, a facility leader shared that facility service chiefs had been forced at times to “provide their best estimates” to inform decisions because of the gaps in metrics.
Over the coming months, VA said it would work with Oracle Cerner to resolve issues with the system’s performance and maximize usability for VA providers. During this “assess & address” period, VA said it would correct outstanding issues—especially those that may have patient safety implications—before restarting deployments at other VA medical centers.
“Right now, the Oracle Cerner electronic health record system is not delivering for veterans or VA healthcare providers – and we are holding Oracle Cerner and ourselves accountable to get this right,” said Deputy Secretary of Veterans Affairs Donald Remy, in a statement. “We are delaying all future deployments of the new EHR while we fully assess performance and address every concern. Veterans and clinicians deserve a seamless, modernized health record system, and we will not rest until they get it, added Remy, who has oversight over VA’s EHR program.
While executing this plan, VA will continue to focus on improvement at the five facilities where the new system has already been deployed. In addition to the system review, VA is sending letters to every veteran who may have been impacted by these system challenges in some manner, asking that if they have experienced a delay in medications, appointments, referrals, or test results, to contact VA through the call center or online. Once they reach out, these veterans can expect a member of their care team to follow up with them within five business days to resolve the issue.
