Congress Questions Leadership of VA Health Record Overhaul

Veterans Affairs Department officials told Congress the initial rollout of their multibillion-dollar health record platform is on schedule, but lawmakers are still waiting for the other shoe to drop.

The system, officially called the Cerner Millennium electronic health record solution, is set to go live at three facilities in the Pacific Northwest in March 2020, following more than a year of skepticism about the project’s viability. The $10 billion overhaul is already projected to run about $350 million over its original budget, but officials on Wednesday assured a House Veterans Affairs subpanel they expect no “significant deviations” from the current spending plan.

But with the launch date rapidly approaching, lawmakers worry the department is diving into the project headfirst without working out the kinks in its management and roll out strategy.

“There are many key decisions and tasks that have yet to be completed,” Chairwoman Susie Lee, D-Nev., said in her opening remarks. “Why insist on leaving yourselves very little margin for error when history is not on your side for successful IT implementations?”

The Millennium system is intended to allow Veterans Affairs to seamlessly share health records with the Pentagon, which is also in the process of standing up a new platform with Cerner Corp. But officials have long warned the effort could fall off the rails without a single point of accountability between the two departments, and the subcommittee isn’t convinced the current oversight structure will do the job.

On March 1, the department leaders finalized their proposal for a joint governance body that would replace the beleaguered Interagency Program Office, which is currently coordinating the respective rollouts. IPO Director Lauren Thompson said the new organization, called the Federal Electronic Health Record Modernization Program Office, or FEHRM, would support efforts at both agencies and have final say over any disputes that arise.

While they acknowledged the proposal was a step in the right direction, lawmakers were quick to point out the FEHRM is still more of a “concept” than reality. The departments haven’t finalized the group’s charter, and its staffing and funding levels are still up in the air, according to Windom. Officials also have not yet named a director or deputy director, or the interim leaders who will precede them, he said.

“For years, the VA and DOD have been promising a joint governance structure,” Lee said in an email to Nextgov after the hearing. “Now … it just feels like they are going through the motions to avoid dealing with the major underlying infrastructure and leadership issues. There is still a lot of risk for failing and until we see a more detailed plan, I remain concerned.”

During the hearing, lawmakers also raised concerns about the numerous technical challenges that must be addressed before the platform can launch at the first trio of sites.

After reviewing the facilities last year, Cerner found the department would need to strengthen networks, update IT infrastructure and perform “necessary facility modifications” before rolling out the platform. John Short, the chief technology integration officer for the agency’s EHR office, told the subcommittee the upgrades will be finished by the March 2020 deadline, but there would likely be additional improvements needed to improve user experience.

Despite those assurances, lawmakers seemed skeptical the department would have facilities ready in time for the launch. If red flags start to pop up, they said it would be best for officials to delay the rollout instead of scrambling to meet the deadline.

“That’s fine if it takes another month or two,” said Rep. Phil Roe, R-Penn., who previously led the full House Veterans Affairs Committee. “I’d rather have you get it right than [do] it quick and get it wrong.”