VA Halts Health Records Deployments Through 2021

Following a series of delayed rollouts and billions of dollars in underestimated costs, the Department of Veterans Affairs will hold off on further deployments of its new electronic health records systems for at least the remainder of 2021.

The decision follows a 12-week strategic review into the first deployment of VA’s Cerner Millennium EHR system in Spokane, Washington, ordered by VA Secretary Denis McDonough.

“We will not be scheduling any deployments in the next 6 months,” Dr. Carolyn Clancy, VA’s assistant undersecretary for health for discovery, education and affiliate networks, told the House Committee on Veterans’ Affairs Wednesday. “The secretary is optimistic that at the end of this calendar year [2021], he will be able to discern a new deployment schedule.”

According to Clancy’s testimony, the review, which ended in June, uncovered “a broad range of issues,” including productivity, patient safety concerns, governance and management, testing, data and training and other concerns. Lawmakers scrutinized VA’s transparency throughout the hearing, repeatedly questioning why the agency severely underestimated the full cost of the new EHR system. The contract—conceived to allow interoperability with the Defense Department’s MHS Genesis health records system—was initially pegged at $10 billion, and later revised to about $16 billion. Two separate VA Office of Inspector General audits, however, indicate the total cost for the system may be as much as $5 billion more because VA significantly underreported estimates for EHR-related physical infrastructure and IT infrastructure.

Clancy said she expects VA to create a new timeline “in the coming months,” and that the agency further plans to inform Congress as it refines its cost estimates. Lawmakers, however, were not sympathetic.

“I’m sorry, but I don’t have a lot of confidence in VA’s ability to produce a credible life cycle cost estimate,” said Rep. Matt Rosendale, R-Mont., ranking member of the Technology Modernization subcommittee. Rosendale added that he wasn’t “interested in shoveling more money into a flawed program” and asked Deputy Inspector General David Chase what improvements he’d need to see in estimates to consider them credible.

In response, Case said VA would need to provide an audit trail for documentation, a sensitivity analysis and an independent cost assessment, which is a requirement under VA policy.

In the coming months, Clancy said VA would be conducting reviews of IT and physical infrastructure requirements “at every facility in our system.” Rather than roll the software out at arbitrary sites, she said the department will “move as an entire organization” based on its findings.

“We will subsequently deploy at facilities in the greatest state of readiness,” Clancy said.