Report: Management Drama Threatens to Derail VA’s Health Records Overhaul

The Veterans Affairs Department’s multibillion-dollar health record modernization effort has been riddled with technical shortcomings and infighting, according to a ProPublica investigation.

The agency in May awarded Cerner Corp. a 10-year, $10 billion contract to stand up an electronic health record platform similar to the one the company was already building for the Pentagon, but officials told ProPublica the software is falling well short of the agency’s needs. A recent progress report by Cerner described the project’s alert level as “yellow trending towards red,” the report published Thursday said.

Veterans Affairs said the contract would enable “seamless” communication with the Pentagon and private medical practices, but the report shows Cerner’s platform isn’t living up to officials’ expectations and many were skeptical even before the contract was awarded. The company’s platform is designed primarily to support insurance billing and it boasted few of the features VA needed for its envisioned lifetime medical record, according to the report.

Disagreements over the deal led department leaders to butt heads with a cabal of Trump advisers who held outsized sway over internal policy decisions and reportedly led to the firing of then-Veterans Affairs Secretary David Shulkin.

“I didn’t want to allow Cerner to think they had achieved this contract and it was for their standard product,” former Veterans Affairs Secretary David Shulkin told ProPublica. “I was really looking to advance the field much further than that.”

The internal disputes didn’t stop after Cerner won the deal either.

Rivals kept Genevieve Morris, the official originally tapped to lead the department’s internal overhaul efforts, in the dark on important information and the power struggle eventually led her to resign along with other high-ranking project leaders, the report said. Lawmakers have chided the agency for its revolving-door of leaders.

Industry experts stressed the need to involve clinicians in high-level decisions, but officials are largely excluding them from the process, the report said.

John Windom, who today serves as the interim leader of the VA’s modernization office after reportedly helping to oust Morris, is suppressing input from physicians, officials told ProPublica. The joint steering committee formed last month by VA Secretary Robert Wilkie and Defense Secretary James Mattis also includes no clinicians, they said.

In the report, officials said the platform was better equipped to handle the acute medical interventions typical of the military health system than veterans’ long-term chronic treatment, and the company’s proposed data transfer plan could put some patients at risk. As Cerner works to accommodate VA’s needs, costs are reportedly on the rise, the report said.

Officials also said the agency is repeating many of the same management mistakes that plagued the Cerner platform’s initial rollout at Defense medical facilities.

“It’s a lesson VA has yet to learn,” an unnamed project staffer told ProPublica, “and a lot of us are concerned they’re going to go down the same road and experience the same adverse health outcomes that DOD experienced.”