VA Secretary: Changes Coming to Electronic Health Records Program

The Veterans Affairs Department will move forward with its multibillion-dollar commercial electronic health records rollout after a 12-week strategic review put the program on pause. The review will lead to significant changes, VA Secretary Denis McDonough said this week, though he declined to share further details.

VA has been working for more than two years with commercial EHR company Cerner to develop and deploy a single records management system across the agency that will also be interoperable with the Cerner-built system being deployed by the Defense Department and the Leidos Partnership for Defense Health.

But five months after the first deployment of VA’s new Cerner Millennium EHR system at the Mann-Grandstaff VA Medical Center in Spokane, Washington, subsequent deployments were put on hold for a 12-week “strategic review” by the new VA secretary.

That review wrapped up at the end of June.

“We began this process after finding that there were systemic failures in the EHRM rollout at the VA Medical Center in Spokane,” McDonough said Wednesday during a press conference. “Our objective was to understand the problems that caused those failures and identify solutions to address them.”

That deployment was initially slated for March 2020 but was delayed first to finalize all the widgets and capabilities for the system and get staff properly trained; then due to the pandemic, as VA shifted to its fourth mission: acting as the nation’s backup health care system.

But even before VA officials opted to postpone the first deployment, watchdogs at the Government Accountability Office released several reports suggesting a delay was needed.

The system finally went live in Spokane in October, amid the ongoing pandemic, a rash of wildfires and a freak snowstorm that knocked out power to much of the city the night of the cutover.

When the Biden administration took office, the newly-confirmed secretary started the strategic review process and paused deployments for 12 weeks.

“We needed to understand what happened to make sure that it doesn’t happen again,” McDonough said at the press conference. “What I can announce today is that the strategic review is complete, and it has already been instrumental in charting the path forward.”

McDonough said that review will result in changes to the program, which he had originally planned to announce at Wednesday’s media briefing.

“I had hoped to announce those changes today, but we need a bit more time to be sure we’re getting them right,” he said.

McDonough did confirm that the program would move forward, continuing to deploy a version of Cerner’s commercial EHR platform. But there will be changes coming.

“We’re very close to finalizing changes to the EHR deployment effort to ensure that we come in on-time, on-budget, and—most importantly—provide the best care for our Vets and the best experience for our providers,” he said. “I assure you that we’ll have further announcements on this soon.”

“Cerner fully supports the secretary’s decision to conduct this strategic review and shares VA’s commitment to getting this right,” Brian Sandager, general manager and senior vice president of Cerner Government Services, told Nextgov in a statement. “Together, Cerner and VA have made progress toward achieving a lifetime of seamless care for our nation’s veterans and we look forward to continuing this important mission.”

During the press conference, the secretary also noted Congress has yet to move on confirming a deputy secretary to lead the program.

“Don’t get me wrong: Dr. Clancy has done and will continue to do a fantastic job,” he said, referring to acting Deputy Secretary Carolyn Clancy. “But Congress directs that the deputy secretary oversee the budget for this process, so I think it reasonable for the Senate to confirm him and allow him to do exactly that.”

President Biden nominated Donald Remy for the post in April. Remy—who currently serves as the COO and chief legal officer for the NCAA—has had a confirmation hearing but is one of a number of VA appointments awaiting a Senate vote.

The Defense Department’s companion effort—MHS Genesis—is continuing apace, with a major test of the system’s interoperability with VA’s version on the horizon. The system will be deployed at the joint DOD-VA Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, in the near future.