Why Lawmakers Are Trying to Nix VA’s $50B+ Dollar Oracle-Cerner EHR Rollout

EHR, EMR, medical record

Two Congresspeople recently introduced a bill seeking to terminate the Department of Veterans AffairsOracle Cerner electronic health record rollout.

The legislation was introduced by Rep. Matt Rosendale (R-Montana) and co-sponsored by Rep. Mike Bost (R-Illinois). Rosendale was recently named chairman of the VA’s subcommittee on technology modernization — this bill is his first piece of legislation in the new role.

“The Oracle Cerner EHR program is deeply flawed — causing issues for medical staff and posing significant patient safety risks,” Rosendale said in a statement. “We cannot continue to further implement this inadequate system at the expense of billions of dollars in government funding. We must hold the VA to the high standard of care promised to our veterans and be good stewards of taxpayer dollars.”

Oracle Cerner did not respond to respond to requests for comment.

It’s difficult to disagree with Rosendale’s classification of the EHR rollout as “deeply flawed.” The project has been plagued with setbacks since its inception.

Initially approved in 2017, the project was designed to install Cerner’s EHR (now branded as Oracle Cerner after Oracle’s $28.4 billion acquisition of the EHR company) at VA hospitals across the country over a 10-year period. A year later, the VA finalized its contract with Cerner, promising the vendor $10 billion to put its hospitals on the same EHR system as the Defense Department. Shortly after, the VA estimated that cost to be closer to $16 million

The effort has faced several delays and postponements since then. Last summer, VA officials said that these consistent setbacks will likely cause the project’s price tag to triple — totaling about $51 billion. This estimation factored in costs outside of the contract, such as staff training and the establishment of organization-wide EHR protocols. VA officials also predicted the rollout would take much longer than expected — about 30 years. 

Both the VA and Oracle Cerner have taken accountability for the long list of delays their project has faced. The VA is now conducting the rollout in accordance with the VA Electronic Health Record Transparency Act — a law President Biden signed last year to grant lawmakers more oversight over issues associated with the rollout. Additionally, Oracle Cerner has a public-facing dashboard that measures progress on software glitches and other issues impacting the success of the project.

In addition to the price tag and timeline revisions, a damaging report also emerged from the VA Office of Inspector General last summer. It said that a software defect in Oracle Cerner’s EHR caused 149 cases of patient harm at Mann-Grandstaff VA Medical Center in Spokane, Washington. Because of the glitch, more than 11,000 orders for services like lab work and specialty care were not delivered. 

This caused the VA to delay its upcoming launches of the new EHR at hospitals across the U.S. In October, the VA extended that delay even further — until June 2023. This decision was made  to “address challenges with the system and make sure it is functioning optimally for veterans and for VA health care personnel,” the department said.

It’s also worth noting that Rosendale and Bost’s new bill came just days after Mann-Grandstaff suffered a service interruption caused by system updates that the Defense Department was making to the overall EHR. Mann-Grandstaff was the first VA hospital to adopt Oracle Cerner’s EHR, and only four other medical centers (of the VA’s 171 across the country) have implemented the software so far.

The legislation calls for an end to the EHR rollout and for VA hospitals to revert back to the department’s internally developed record management system. The bill said that even though Oracle Cerner’s EHR has only been implemented at five small to medium facilities, it has caused unacceptable levels of patient safety risk, staff burnout and productivity loss.

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