VA's latest EHR go-live: 'not flawless, but we're rolling'

The Department of Veterans Affairs launched its new commercial electronic health record system at a second site on March 26, and according to the agency's chief, the switch is going as planned.

The launch, at Walla Walla VA Medical Center in Washington, went ahead as scheduled despite three highly critical oversight reports from the agency's inspector general looking at problems and risks arising from the initial go-live at Mann-Grandstaff VA Medical Center that were released just days ahead of the Walla Walla launch.

At a House Appropriations hearing on Wednesday, McDonough acknowledged some of the problems addressed in the reports but said that the VA was proceeding with its schedule.

"Walla Walla is only 10 days in, but it's going actually on the higher end of expectations," McDonough said. "That doesn't mean it's been flawless, but we're rolling."

The VA is seeking $1.8 billion for the electronic health records modernization program for FY2023. That covers 19 new deployments and preparatory activities like infrastructure modernization and training at new sites. 

"This is a slightly smaller request than I think was anticipated," McDonough said. "The first thing is it recognizes that the rollout is much slower because of how challenging Mann-Grandstaff has been."

McDonough added: "What we're going to do is let the data and expertise drive this. We're not going to try to force some timeline. We're going to try to learn lessons."

The new health record, provided by Cerner, is part of a $25 billion-plus effort to put VA and the Defense Department into a joint, interoperable system that follows servicemembers from induction through active duty and VA care.

After Walla Walla, the next go-live is scheduled for the VA Central Ohio Healthcare System and affiliated clinics in the spring. Patients there who receive health care or direct benefit payments are being advised to update any name changes with DOD's  Defense Eligibility Reporting System (DEERS) and with VA before the transition to the new system. 

One of the three IG reports noted that problems with migrating data from VA's legacy electronic health record system resulted in outdated information from DEERS overwriting more recent information from VA in the new system.

As a workaround, patients are being asked to fax or mail signed letters with copies of identifying documents to DOD and to mail or hand-deliver similar documentation to a local VA medical center. Separate documentation must be filed with each VA program office – disability, education, home loans or rental assistance, life insurance, pension benefits education and training – that an individual uses.

According to Roger Baker, who served as VA chief information officer from 2009 to 2013 and participated in discussions about establishing a joint DOD-VA system, the stringent requirements of the DEERS system were an issue back then.

"We said we couldn't force anyone who wants to change their name in the VA system to go through the DOD process," Baker told FCW. "Here we are 10 years later, and they're doing exactly what we said we couldn't do 10 years ago, from a customer service perspective."