VA’s planned restart of EHR rollouts draws lawmaker concern

The Department of Veterans Affairs is looking to restart deployments of its beleaguered Oracle Cerner electronic health record system at additional medical facilities in fiscal year 2025, but lawmakers said the results of the agency’s most recent rollout does not justify efforts to resume the project.

VA announced in April 2023 that it was pausing additional deployments of the EHR system to address a series of technical glitches, patient safety concerns and other issues plaguing the medical facilities where the new software had been deployed. 

While the so-called “program reset” remains in effect for all other VA facilities, the department carried out its planned rollout of the new EHR software at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, in March. 

That deployment — a joint effort between VA and the Department of Defense — marked DOD’s last rollout of its own new EHR system and VA’s largest rollout to date of its software at a medical facility. Both VA and DOD have been implementing an interoperable Oracle Cerner EHR system to ensure servicemembers’ health records can easily transition from active service back to civilian life.

VA officials have said that the Lovell deployment would be a key test of the department’s ability to exit the reset period, and have since called the EHR modernization project at the site a success. During an April congressional hearing, VA Secretary Denis McDonough told lawmakers that the department plans to exit the reset period and resume deployments in fiscal year 2025. 

During a House Veterans’ Affairs Subcommittee on Technology Modernization hearing on Monday, however, lawmakers expressed bipartisan concern about VA’s plans to restart the project at this juncture.

Rep. Matt Rosendale, R-Mont., who chairs the panel, said “I have serious concerns that Secretary McDonough is about to put the Department of Veterans Affairs, and the veterans it cares for, in a dangerous situation by resuming the go-lives on a large scale.”

He noted that the rollout at the joint DOD-VA facility has been more successful than other EHR deployments because of an influx of new staff and “nearly 800 experienced users from other military treatment facilities, contractors and experts from the VA central office pitching in immediately after the go-live.”

Lawmakers at the hearing also drew a contrast between the additional personnel and funding needed to implement the EHR system at Lovell and the likely decline in deployment-related resources at future VA medical facilities.

VA’s fiscal year 2025 budget request does not allocate any money toward the deployment of its new EHR at additional medical facilities, but VA McDonough said it has “existing money” that will be made available to resume system rollouts.

Rep. Sheila Cherfilus-McCormick, D-Fla., the subcommittee’s ranking member, said that “while [Lovell] may have been more successful than previous attempts, I think we are far from ready to endorse further go-live activities.”

She said the facility “had the luxury of being the sole focus of both VA and DOD EHR modernization programs,” with both departments expending “more resources at this go-live than will ever be available at any future VA facility.”

According to a staffer on the House Veterans’ Affairs Committee, VA is considering four medical center go-lives during FY25, while Oracle has proposed eight go-lives during the same period. 

Dr. Neil Evans — acting program executive director of VA’s Electronic Health Record Modernization Integration Office — told lawmakers the reset period has allowed the department to address a number of issues at the six VA facilities currently using the new software and that “our focus during the reset will continue even after we restart deployment related activities.”

Lawmakers also pressed VA officials during the hearing to provide an updated cost analysis for the entire project to account for the deployment pause and additional resources needed to right the project.

Although VA signed a 10-year, $16 billion contract with Cerner — which was later acquired by Oracle in 2022 —to complete the EHR modernization project, a cost estimate conducted by the Institute for Defense Analyses placed the total needed at $50 billion over 28 years. 

Evans pushed back on the Institute for Defense Analyses’ figure but also said he could not provide an updated cost estimate for the entire EHR modernization project because it “would require us to have a schedule for what the further deployments are going to be.”