Lawmakers propose more scrutiny of VA's new EHR, reauthorize VET-TEC program

The Tibor Rubin Veteran Affairs Medical Center in Long Beach, Calif.

The Tibor Rubin Veteran Affairs Medical Center in Long Beach, Calif. Scott Varley/MediaNews Group/Torrance Daily Breeze via Getty Images

The bipartisan legislative package includes new oversight metrics for VA’s Oracle Cerner electronic health record system but would end the modernization effort if facilities using the software don’t show improvement.

Bicameral leaders of the House and Senate Veterans’ Affairs committees introduced a legislative package on Tuesday designed to improve resources for retired servicemembers, including proposals that would enhance the Department of Veterans Affairs’ oversight of its new electronic health record system and extend a popular veteran tech training program. 

The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act was introduced by Rep. Juan Ciscomani, R-Ariz., a member of the House committee. The bill has the backing of Sen. Jon Tester, D-Mont., the Senate committee’s chair, as well as Rep. Mike Bost, R-Ill., who chairs the House panel. 

VA’s effort to deploy a modernized EHR system at its medical facilities has been beset by technical challenges, patient safety concerns and cost overruns since the agency signed a five-year contract with Cerner in 2018 to modernize its legacy software. Oracle acquired Cerner in 2022, but issues with the system’s rollout have continued since then. 

VA announced in April 2023 that it was pausing additional rollouts of the EHR system as part of a “program reset” to address problems with the software. The Oracle Cerner system has been deployed at just six VA medical facilities.

Lawmakers have introduced a variety of measures to improve the modernization project over the past few years, including bipartisan legislation that President Joe Biden signed into law in June 2022 requiring VA to provide Congress with quarterly reports about the program, such as its expenses and performance metrics. 

Tuesday’s legislative package has provisions that would expand the metrics included in the quarterly reports to Congress by adding, in part, data “on user adoption and employee satisfaction” with the new system and “data on employee retention and turnover at medical facilities where such electronic health record system is in use.”

The proposal would also limit “preliminary program activities” related to rolling out the software at additional VA medical facilities until the VA secretary certifies the sites are ready and provides corroborating data to Congress “demonstrating that all facilities currently using the Oracle Cerner EHR system have recovered to normal operational levels.”

If the Oracle Cerner EHR system’s rollout does not show improvement, then the measure would also sunset the project. Two years following the bill’s enactment, the VA secretary would be required to end the modernization program and terminate its contract with Oracle Cerner unless he or she submits metrics to Congress that “show overall improvement in each measurement period” for the software deployed at each of the department’s medical facilities.

VA would also be directed to provide an annual report to Congress on its efforts to maintain its legacy EHR system, known as the Veterans Health Information Systems and Technology Architecture, or VistA. This report would mandate that the department include, in part, details about “the operation and maintenance costs and development and enhancement costs” of the software and “a list of modules, applications or systems” within VistA that VA plans to retire or continue to use. 

“By improving veterans’ access to the care they need, bolstering long-term care options and assistance for homeless veterans, strengthening life-saving mental health services and increasing transparency and oversight of VA’s new electronic health record program, this package is a common sense step towards delivering veterans and their families the kind of support they earned and deserve,” Tester said in a statement about the legislation.

The bill would also renew the department’s popular tech training pilot — known as the Veteran Employment Through Technology Education Courses program, or VET-TEC — that expired in April. The five-year pilot, which launched in 2019, provided eligible veterans with financial assistance to take high-tech education training courses with approved providers.

The bill would extend VET-TEC through September 2026 and would allow up to 4,000 veterans to enroll in the program in any fiscal year. A spokesperson for Tester told Nextgov/FCW last month that VET-TEC’s reauthorization was going to be included in the bipartisan package of bills that lawmakers were crafting.