VA Extends Delay of EHR Rollout Until June 2023 to Address ‘Outstanding Issues’

The Veterans Affairs Department announced on Thursday that it was extending the delay in the rollout of its multi-billion dollar Oracle Cerner Millennium electronic health record system until June 2023 to address continuing technical and performance issues with the software.

In a press release, the VA said it “will continue to work closely with Oracle Cerner to resolve issues with the system’s performance, maximize usability for VA health care providers and ensure our nation’s veterans are served by an effective records system to support their healthcare.”

“During this ‘assess & address’ period, we will correct outstanding issues—especially those that may have patient safety implications—before restarting deployments at other VA medical centers,” the VA said, noting that the delay was needed “to address challenges with the system and make sure it is functioning optimally for veterans and for VA health care personnel.”

The EHR software’s deployment across the VA’s national network of 171 medical centers has been bogged down by system outages, cost overruns, patient safety concerns and technical issues since it first went live in 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington. A highly critical report released by the VA Inspector General’s office in July found that the EHR system’s deployment at Mann-Grandstaff improperly routed over 11,000 clinical orders for veterans to an “unknown queue” without the knowledge of clinicians.

VA officials previously announced in July that they were delaying the rest of the scheduled rollouts of the EHR system at VA medical facilities until early 2023 to address patient safety concerns and technical issues that impeded the rollout of the new software. The VA’s EHR deployment schedule, which has not been updated since the latest delay was announced, has the system scheduled to go live at 25 medical sites in the 2023 fiscal year. The VA has only deployed the new system at five medical facilities so far.

“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,” Deputy Secretary of Veterans Affairs Donald Remy said 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.”

VA said it plans to use the additional time to review the five medical facilities where the EHR system has been deployed and will send 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.”

In addition to the delay, The Spokesman-Review reported on Thursday that the VA “confirmed it was aware of the death in late September of a patient at the VA clinic in Columbus, Ohio” that was attributed by the facility’s assistant chief of pharmacy “to incorrect information in the Oracle Cerner system.” The patient’s death is reportedly being treated as a possible “sentinel event.”

Lawmakers on both sides of the aisle have also excoriated the VA and Oracle Cerner over their handling of the EHR system’s deployment, with President Joe Biden signing bipartisan legislation—the VA Electronic Health Record Transparency Act—in June that gave Congress additional oversight over problems related to the system’s rollout. Congressional leaders have also balked at an estimate provided by the Institute for Defense Analyses that places the cost of the EHR system’s implementation across all of the VA’s medical centers at more than $50 billion over 28 years.

Following the VA’s announcement that it was extending the delay in the EHR system’s rollout, leading lawmakers on House and Senate committees overseeing the department expressed renewed concerns about efforts to address systemwide issues with the software. 

Rep. Mike Bost, R-Ill., ranking member of the House Veterans’ Affairs Committee, told Nextgov in a statement that he has “long said that the new electronic health record should not be rolled out anywhere else until Oracle Cerner fixes its serious problems.”

“I am glad to see that the secretary and his team agree with me,” Bost added. “When I visited Walla Walla [Washington] in July and Columbus [Ohio] in September, the staff made it clear that this flawed system is making their jobs more difficult and crippling the delivery of care to veterans, and I have heard the same thing from the other sites. Unfortunately, these delays are nothing new. VA and Oracle must prove that this time is different, and I won’t allow them to continue throwing good money after bad.”

During a committee hearing in July, Bost said that lawmakers should “seriously consider pulling the plug” on the EHR system’s rollout and that he would “be writing legislation to do just that."

Sen. Jon Tester, D-Mont., chairman of the Senate Veterans’ Affairs Committee, also said in a statement that “the new EHR simply cannot be deployed before it's ready for prime time.”

“When it comes to delivering the quality health care our nation’s veterans have earned, we have to hit the mark the first time around,” Tester added. “That’s why I’ll continue holding VA and Oracle Cerner’s feet to the fire in fixing systemwide issues so existing facilities and any future rollouts guarantee VA health care staff have the tools to provide veterans safe, timely care.”

An Oracle representative did not respond to a request for comment. 

During a Senate Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies hearing last month, Mike Sicilia—the executive vice president for industries at Oracle, which acquired Cerner in June—told lawmakers that the company launched a dashboard to track “our to-do list and progress being made” on the project.

As of Oct. 13, the public-facing dashboard—the link to which Oracle previously shared with Nextgov—shows that the company has closed out seven “assigned issues as originally identified by VA as priorities in February and May 2022 briefings to Congress and as cited in a letter from Congress to VA on June 27, 2022.” 

Oracle’s dashboard lists eight other issues to address that are in progress; another four issues that are scheduled; and two others that are marked as “in development.”