Congressman Raises Concerns about "Deteriorating, Rudderless” Leadership of VA’s EHR Project
Last week, Genevieve Morris stepped down from her role as Chief Health Information Officer at the Department of Veterans Affairs’ newly established Office of Electronic Health Record Modernization (OEHRM), just 40 days into the role of overseeing the VA’s massive $16 billion EHR modernization project.
One federal lawmaker, Rep. Jim Banks, (R-Ind.), who serves as the chairman on the House Veterans’ Affairs Subcommittee on Technology Modernization, a subcommittee that provides oversight on the project, has voiced concerns about the direction and leadership of the project and the potential bureaucratic challenges the project faces less than four months after department officials finalized the EHR contracts.
In his letter to VA Secretary Robert Wilkie, Banks said he is concerned about the “deteriorating and rudderless leadership" of the OEHRM program, citing the resignation of Morris, as the program’s top leader, and coming only three days after the resignation of Ashwini Zenooz, the chief medical officer in charge of the department's EHR implementation.
“As a result at most half of the program’s senior leadership positions are occupied, and its rank-and-file positions are only sparsely filled, primarily with detailees,” Banks wrote. “This comes at a time when VA is making the most pivotal decisions as to the design of the Cerner EHR system to be implemented, as the program’s previous leadership team declared that a ‘go-live clock’ will begin on October 1, 2018 and culminate in the implementation of the system at its first site in March 2020.”
VA signed a contract with Cerner Corp. on May 17 to replace its decades-old Veterans Integrated System Technology Architecture (VistA) EHR technology over the next 10 years with the new Cerner system, which is in the pilot phase at the Department of Defense (DoD). The system is designed to allow the VA to have patient data shared seamlessly between VA and DoD.
The VA plans to begin deployment of the new $16 billion EHR system at three sites in the Pacific Northwest—Spokane, Seattle and American Lakes, all in Washington—in October 2018 with a goal of full capability by March 2020. However, the ongoing leadership changes and shakeups are troubling to many lawmakers.
Previously, Morris, a health IT policy leader, had been detailed to the VA from her position as the principal deputy national coordinator for the Department of Health and Human Services (HHS) and then moved over full time to lead OEHRM in July.
As reported by Healthcare Informatics, in her resignation letter to Sec. Wilkie and Health and Human Services (HHS) Secretary Alex Azar, Morris wrote, “Over the last few weeks, it has become clear to me that VA’s leadership intends to take the EHR modernization effort in a different direction than we were headed, and since my service as CHIO was always intended to be an interim solution, I am offering my resignation to the administration effective immediately.” The VA has appointed John Windom as acting CHIO for VA’s OEHRM program. Windom has been the executive director for VA's Electronic Health Record Modernization (EHRM) since August 2017.
During a House committee hearing on the VA’s Cerner EHR project back in June Rep. Tim Walz (D-Minn.) said, “Leadership will make or break this project, as will the oversight. EHR modernization is a big bet on the future of VA and we simply must make sure it succeeds.”
In the letter to Sec. Wilkie, Banks also wrote that it would be a “tragedy” for the program to be “undermined by personality conflicts and bureaucratic power struggles before it even begins in earnest.”
Banks said that, despite several requests, he was not able to meet with the EHRM leadership team before their departures and pointed out that “any engagement is difficult without stable leadership. He urged Sec. Wilkie to identify a permanent CHIO who possesses the “requisite medical and technical knowledge and demonstrates managerial competency for such a large EHR transition.” And, he urged VA leadership to select a CMO from within the VA. “It is crucial that this person commands the respect of the VHA workforce, as he or she must represent its views in the extremely sensitive task of redesigning clinical processes.”
Rep. Banks also requested a detailed organizational chart of the OEHRM listing each federal position and full-time contractor position and indicating the name of each position’s incumbent or its vacant status by September 7.
