House Lawmakers Coalesce Around Bipartisan Fixes to VA’s EHR System

Leading Democrats on the House Veterans’ Affairs Committee are working with the committee’s GOP chairman to introduce legislation that would address accountability and oversight concerns associated with VA’s deployment of its new multi-billion dollar Oracle Cerner electronic health record system, lawmakers said on Wednesday. 

The news came during a legislative hearing held by the House Veterans’ Affairs Oversight and Investigation Subcommittee, which discussed four bills—two from Democrats and two from Republicans—that are focused—fully or in part—on challenges plaguing VA’s new EHR system. Lawmakers also discussed legislation from subcommittee Chair Jen Kiggans, R-Va., focused on improving supply chain issues within the VA. 

The top Democrats and Republicans on the House and Senate Veterans’ Affairs committees have all introduced separate legislation in the 118th Congress to rectify challenges with the Oracle Cerner EHR system’s deployment, which have included patient safety concerns, technical and performance issues, cost overruns and deployment delays. VA announced last October that it was pausing future rollouts of the new software to “address challenges with the system,” and the department announced earlier this month that it was postponing its planned June resumption of future site rollouts. 

Wednesday’s hearing gave VA officials the opportunity to provide feedback on several of the proposals, including a GOP-backed bill that would require VA medical facilities to meet certain performance and facility readiness standards before the EHR system is deployed; another GOP-backed bill that would terminate the EHR modernization program; a Democratic bill to create a VA under secretary for management position to, in part, oversee departmentwide acquisition and IT initiatives; and another Democratic proposal that would require VA to hire an independent contractor to verify and validate major IT modernization projects across the department, including implementation of the new EHR system.

Sen. Jon Tester, D-Mont., who chairs the Senate Veterans’ Affairs Committee, is also the lead sponsor of legislation—known as the EHR Program RESET Act—that would “restructure, enhance and strengthen the entire EHRM program while also mandating aggressive reporting to Congress to increase oversight, accountability and transparency following a series of challenges with the system and program.” 

The committee’s top Republican, Sen. Jerry Moran, R-Kan., is also the sponsor of another bill that would prevent future deployments of the EHR system at medical facilities until the VA secretary certifies in writing to the House and Senate Veterans’ Affairs committees that the system has met outlined “improvement objectives.”

One of the bill’s discussed during Wednesday’s House hearing was H.R. 592, or the VA Electronic Health Record Modernization Improvement Act. Introduced by Rep. Mike Bost, R-Ill.—who chairs the full House committee—the legislation would require that, moving forward, the directors of VA medical facilities submit written certification to VA Secretary Denis McDonough stating that they have met mandated performance and facility readiness standards before the Oracle Cerner software is deployed.

Phillip Christy—the deputy executive director of VA’s Office of Acquisition, Logistics and Construction—told the committee that the department “supports, in part” Bost’s legislation, noting VA’s agreement with the bills requirement “that VA continue to partner with the Department of Defense and the Federal Electronic Health Record Modernization Office to improve overall performance within the EHR and the systems connected to it.”

“However, VA does not fully support some of the specific prohibitions and certification requirements,” he added. “As currently written, the proposed limitations would pause program activities and cause significant cost impacts. We suggest modifications to the bill text to ameliorate these concerns, and we believe the modifications would work towards facilitating the intent of the bill.”

House lawmakers, however, signaled during the hearing that they are beginning to coalesce around Bost’s bill, as well as Tester’s proposed legislation, as potential bipartisan solutions for improving VA’s EHR system rollout. 

Rep. Mark Takano, D-Calif., the full committee’s ranking member, said that he was working with Bost “on a long-term solution to the EHRM program with our planned introduction of Senator Tester’s EHR RESET Act this week.”

“We've had a lot of success working together on a bipartisan basis, and I look forward to continuing to work across the aisle to fix this problem,” Takano added.

A spokesperson for Bost confirmed that the chairman would be introducing the EHR Program RESET Act along with Takano, and added that Takano would also be co-sponsoring Bost’s legislation. A representative for Takano did not respond to a request for comment. 

“[H.R.] 592 will be part of any agreement, along with elements of RESET,” the spokesperson said, referring respectively to Bost’s bill and Tester’s legislation. They added that the lawmakers’ collaborative efforts “represent the start of bipartisan negotiations.”

Rep. Frank Mrvan, D-Ind., the subcommittee’s ranking member, announced during the hearing that he will also co-sponsor the House version of Tester’s legislation.

“This bill is an ideal platform for negotiating a long-term, bipartisan fix to the program,” Mrvan added. “This bill will address a number of issues, including [those outlined] in Chairman Bost’s legislation today, and I look forward to collaborating across the aisle as we successfully accomplished last Congress.”