Republican representative Mike Bost is calling for legislation to be advanced in Congress cracking down on the management of the Department of Veterans Affairs EHR modernisation (EHRM) by Oracle Cerner. The vendors have been blamed for much of the troubled EHR’s implementation, and six “catastrophic harm” incidents have been reported. Bost and 10 Republican co-sponsors recently introduced legislation that would bar the VA from future rollouts of the EHR at VA medical facilities until sites certify that the health IT has met performance and facility readiness metrics.
The Department of Veterans Affairs (VA) has been trying to modernize its EHR system for years, but its attempts have been met with multiple setbacks and failures. The latest effort, known as the EHR modernization (EHRM) project, has faced issues with software outages, cost overruns, and patient safety. According to a briefing on March 15, 2023, VA officials informed the Senate committee staff of six “catastrophic harm” incidents, including four veteran deaths, linked to patient safety issues with the EHRM project.
The project has been plagued with issues since its inception, with vendors Oracle and Cerner receiving much of the blame for the troubled implementation. Rep. Mike Bost (R-Ill), the top Republican on the House VA Committee, has called on Congress to advance legislation cracking down on Oracle Cerner’s management of the project. Bost and 10 Republican co-sponsors have introduced legislation that would bar the VA from future rollouts of the EHR at VA medical facilities until sites certify that the health IT has met performance and facility readiness metrics.
The VA has used its legacy EHR, the Veterans Health Information Systems and Technology Architecture (VistA), for over four decades. The department has tried and failed several times to modernize the system. According to Gene Dodaro, comptroller general, VA has spent more than $1.7 billion on failed predecessor EHR systems before the new Oracle Cerner platform.
Cerner, acquired by Oracle last June, received a $10 billion contract in 2018 to update VA’s EHR. However, the deployment of the new system has been slow and has not met expectations, with some VA facilities reporting issues with the system. Last October, VA announced that it was extending a previous delay on additional rollouts of the Oracle Cerner system until June 2023 “to address challenges with the system and make sure it is functioning optimally for veterans and for VA health care personnel.”
Bost blamed the vendors for much of the EHR’s troubles, stating that “it’s Cerner and Oracle that need to get their act together.” He noted that VA must ensure that the standards are met at the site where the system is rolled out, and the most important standard is that the operator, manager, and overseer of the particular VA medical facility are comfortable moving forward with changing the system.
Bost is also a co-sponsor of legislation that “would end the Oracle Cerner electronic health record program at VA if it cannot demonstrate significant improvement but is nonetheless introduced to additional medical centers.” He believes that if the VA cannot get its act together, that will force its hand to get it together.
VA’s contract with Oracle Cerner will expire on May 16, and legislators have called on the agency to negotiate a new contract that imposes stricter penalties for poor system performance. Bost said VA should push for better terms in any new agreement, adding that “VA should have been doing that before I carried a bill.”
Overall, the EHRM project’s difficulties have raised concerns about the impact on the quality of care for veterans and the cost of implementing a new system. The legislation introduced by Bost and his colleagues aims to hold vendors and the VA accountable for ensuring that the EHR meets performance and facility readiness metrics before deployment to ensure that the health IT system does not endanger the lives of veterans.
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