Lawmakers Question Resuming VA Oracle EHR Rollout At Subcommittee Hearing

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Dive Brief:

• Lawmakers raised concerns about resuming deployments of the Oracle electronic health record at Department of Veterans Affairs medical facilities during a House subcommittee hearing this week. 
• The recent launch of the new EHR at the Captain James A. Lovell Federal Health Care Center, a joint VA and Department of Defense facility in Illinois, went well, VA and Oracle officials testified. New deployments of the EHR have largely been on hold for more than a year to improve the system’s reliability and performance. 
• However, legislators argued the rollout at Lovell required additional staff, and some problems haven’t been fixed. “I think we are far from ready to endorse further go-live activities,” said Rep. Sheila Cherfilus-McCormick, D-Fla. “The two departments threw more resources at this go-live than will ever be available at any future VA facility.”

Dive Insight:

The deployment of the new EHR has been a yearslong challenge, plagued with technical issues and patient safety concerns.

EHR vendor Cerner — later acquired by technology giant Oracle — scored the contract to modernize the VA’s health record system in 2018. But only six VA medical centers have deployed the new EHR so far, as users grappled with system reliability problems and errors that could result in patient harm. 

Legislators have also raised concerns about the project’s cost, as the VA faces a historic budget shortfall of nearly $15 billion for the remainder of the 2024 and 2025 fiscal years.

“The Oracle Cerner EHR is simply not good enough today to enable a bare minimum of efficiency at the VA, let alone the high quality care our veterans deserve, without a huge influx of extra staff and money,” Rep. Matt Rosendale, R-Mont., said during the House Committee on Veterans’ Affairs subcommittee hearing on Monday. 

New rollouts of the EHR were largely put on hold in April 2023, except for the planned deployment at Lovell in North Chicago that took place in early March this year. In April, VA Secretary Denis McDonough said the agency plans to resume the Oracle EHR rollout by the end of the 2025 fiscal year. 

The pause aimed to address problems at facilities where the new EHR was already live, invest in enterprise work necessary for long-term success and prepare for the deployment at Lovell, Neil Evans, acting program executive director of the VA’s Electronic Health Record Modernization Integration Office, told the subcommittee.

It’s still too early to declare the latest rollout a clear success, but results at Lovell have been “promising,” Evans said. 

The medical center maintained 100% capacity for its emergency room and inpatient bed census for mental health throughout the deployment. Inpatient census for acute medical and intensive care has returned to baseline after a 50% reduction when the EHR went live, he testified.

“I’m going to say it’s going very well,” said Lovell Director Robert Buckley. “I’m going to say it’s going better than anyone expected.”

That outcome is in part due to new training and change management programs, leading to faster adoption rates and less time spent in the EHR compared with previous live sites, said Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences. Verma was the CMS administrator under President Donald Trump.

The Lovell deployment and improvements at the other five facilities using the EHR offer proof they can implement the health record at new medical centers, she said. 

“In parallel to ongoing enhancement efforts, pre-deployment work at future sites should restart this fall, and new deployments at those sites should be planned for next year,” Verma said. “Oracle’s ready to get restarted and to bring the benefits of this new EHR to more veterans across the country.”