House Lawmakers Introduce Bipartisan Bill to Reform VA’s EHR Program

A coalition of House Democrats and Republicans introduced legislation this week to improve the deployment of the Department of Veterans Affairs’ new Oracle Cerner electronic health record system, marking the first bipartisan effort of the 118th Congress to address oversight concerns with the multi-billion dollar modernization program’s rollout. 

The bill is the House companion of the EHR Program RESET Act, legislation introduced last month by Sen. Jon Tester, D-Mont., chairman of the Senate Veterans’ Affairs Committee. It was formally introduced on April 24 by Rep. Mark Takano, D-Calif.—ranking member of the House Veterans’ Affairs Committee—and Rep. Mike Bost, R-Ill.—who chairs the panel—along with eight bipartisan co-sponsors.

The bill’s introduction came after VA announced on Friday that it would be delaying additional rollouts of the EHR system until the department is confident “that the new EHR is highly functioning at current sites and ready to deliver for veterans and VA clinicians at future sites.” VA previously announced last October that it would be pausing future deployments of the software until June 2023 to “address challenges with the system,” which have included patient safety issues, software usability concerns and system outages. 

The House bill would, in part, reform the EHR modernization effort by establishing a program management office within the Veterans Health Administration and reorganizing the reporting structure for the project’s functional champion and deputy chief information officer. 

Under the proposal, VA would also be required to ensure that the five medical facilities currently using the Oracle Cerner software meet or exceed certain performance baselines before the EHR system is deployed at any additional sites. If VA and Oracle Cerner are not able to meet the outlined requirements—which would be set by VA’s Office of Information and Technology and the VHA—then the bill directs the department “to consider terminating or canceling the current contract and requires VA to provide an alternative plan for a solution.”

The legislation also includes the text from Takano’s Department of Veterans Affairs IT Modernization Improvement Act, which would require VA to “enter into a contract for the independent verification and validation of certain modernization efforts,” including the EHR system’s rollout. 

In a statement, Takano said that the bipartisan House proposal “will provide a framework for fixing the EHRM program and ensuring that VA fixes problems where the new health records system is in use before any new deployments.”

“The guiding priority for the program should be ensuring veterans are not harmed by the system and that it allows VA clinicians to provide excellent care,” he added. “I’m pleased to be working with Chairman Bost on introducing this bill in the House and look forward to the House and Senate coming together on a much-needed solution for this troubled IT program.”

Prior to the bipartisan proposal’s rollout, the top Democrats and Republicans on the House and Senate Veterans’ Affairs committees had all introduced separate bills to address concerns with the EHR system’s deployment. This included legislation from Bost—the VA Electronic Health Record Modernization Improvement Act—that would require the directors of medical facilities to certify in writing to VA Secretary Denis McDonough that their sites have met outlined performance and facility readiness standards before the new EHR system is deployed. 

The backers of the House bill signaled that their legislation is designed to kickstart bipartisan and bicameral talks. In a press release, the bill’s sponsors said the proposal will “begin negotiations between the House and Senate to address longstanding issues with the management and delivery of VA’s ongoing Electronic Health Record Modernization.” 

Democratic lawmakers first announced the introduction of the bipartisan bill during a legislative hearing held by the House Veterans’ Affairs Oversight and Investigation Subcommittee on April 19. After the hearing, a Bost spokesperson said that Takano would also be co-sponsoring Bost’s bill, which they said would be “part of any agreement, along with elements of RESET.”

The same day the bipartisan proposal was formally introduced in the House, Takano and two other Democratic backers of the bill—Kim Schrier, D-Wash., and Greg Landsman, D-Ohio—signed on as co-sponsors of Bost’s legislation. 

In a statement, Bost thanked Takano for also supporting his bill, which he said “is critical to resolve the system’s impacts on the existing VA facilities and protect additional facilities by listening to the VA healthcare staff on the ground.”