Chicago phase of VA's health record software deployment is live amid larger program 'reset'

The Department of Veterans Affairs officially announced on Saturday that it has launched its Oracle Cerner electronic health record system at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, marking the first — and only — deployment of the new software in tandem with the Department of Defense’s system.

The rollout of the joint EHR system at Lovell also marks the final deployment of DOD’s new software — known as MHS Genesis — at department hospitals, facilities and clinics located across the globe. 

Both DOD and VA contracted with Cerner to modernize their legacy health record systems and deploy new software that is interoperable across both agencies, with the goal of ensuring that transitioning veterans’ medical records can seamlessly move from one department’s system to the other. Cerner was subsequently acquired by Oracle in December 2021. 

Lovell is the only fully integrated VA and DOD facility in the nation, delivering medical services to roughly 75,000 patients each year. Robert Buckley, the facility’s director, said in a statement that the launch of the combined EHR system “enables a continuum of care that will enhance our operations as we work to optimize health outcomes for those we serve.”

While Saturday’s deployment at Lovell marks the culmination of DOD’s roughly seven-year effort to roll out a modernized EHR system across its healthcare operations, VA is continuing to experience challenges with implementing its new Oracle Cerner system, known as Millennium, that first began in 2020. 

VA paused deployments of its new software — with the exception of Lovell — in April 2023 as part of a larger “program reset” to address technical issues and patient safety concerns at the five other VA medical facilities using the new EHR system.

A VA spokesperson told Nextgov/FCW in December 2023 that the pause in deployments would continue until the department is confident that the software is functioning properly at the current sites and is demonstrating “measurable improvements in the clinician and veteran experience.”

The EHR system’s deployment at Lovell, however, was excluded from VA’s pause and was viewed by officials as an integral component of the department ultimately restarting efforts to implement the new software at additional VA medical facilities. 

Why Chicago matters to the reset 

During a media roundtable on Friday, Dr. Neil Evans — acting program executive director of VA’s Electronic Health Record Modernization Integration Office — said one of VA’s goals during the reset “has been to really put the resources into preparing for a go-live at [Lovell], particularly given its unique status as a joint site.”

“This really has been a part of the reset for us,” he added, calling it part of the department’s path toward restarting EHR system rollouts “as we learn from this deployment and as we've been doing this together with the DOD.”

Evans said the five VA facilities currently using the Oracle Cerner EHR system are “small- to medium-sized facilities,” noting that “there's value in going live at a more complex site with a higher inpatient volume” like Lovell.

When it comes to VA’s broader efforts to streamline operations at the VA medical facilities using the new EHR system during the reset period, Evans said officials “have been seeing improvements” at the sites and are focusing on improving the department’s software deployment methodology, as well as working to “better support all of our staff members through the training that we provide.”

Issues previously identified with the EHR software’s pharmacy system have also been largely rectified, Evans said. A February report from VA’s Office of Inspector General warning that interoperability issues between VA medical facilities using the new Oracle Cerner system and those still using the department’s legacy software resulted in some 250,000 veterans in danger of being given contraindicated medications.

Evans said VA has implemented “a series of improvements in the pharmacy capability” over the past year and deployed a fix last April to remedy discrepancies in veterans’ medical records, although he said that some of the ”drug interaction checks need to be sort of manually verified, and clinicians have been made aware at VA of how to do that.”