VA plans 'strategic review' of $16B Cerner program

NOTE: This article first appeared on FCW.com.

Veterans Affairs chief Denis McDonough announced a "strategic review" of the agency's $16 billion Electronic Health Record Modernization program of up to 12 weeks.

The move comes 20 weeks after the new system, based on the Cerner Millennium EHR software, went live at the Mann-Grandstaff Medical Center in Spokane, Wash., four outpatient clinics and at an affiliated billing and processing center in Las Vegas.

"A successful EHR deployment is essential in the delivery of lifetime, world-class health care for our Veterans," McDonough said in a statement. "After a rigorous review of our most-recent deployment at Mann-Grandstaff VA Medical Center, it is apparent that a strategic review is necessary. VA remains committed to the Cerner Millennium solution, and we must get this right for veterans."

Last November, program leaders said the go-live had gone well from a technical perspective, avoiding some of the infrastructure headaches and permissions problems that had plagued the Defense Department's launch of the same software.

Just this week, however, Rep. Cathy McMorris Rodgers, a Republican congresswoman who represents Spokane and serves as ranking member of the House Energy and Commerce committee, wrote to McDonough to air constituent complaints about the new system.

"The system is not an improvement," Rodgers wrote. "It has put new stress on the Mann-Grandstaff VA Medical Center, which is a vital lifeline for so many of our veterans and has struggled with staffing and morale for several years."

In a statement March 19, Rodgers said that she was "encouraged to see Secretary McDonough respond swiftly to my calls for review of the broken electronic health record system that has caused new stress on veterans and VA staff in Eastern Washington."

Rep.  Mike Bost (R-Ill.), the ranking member of the House Committee on Veterans' Affairs, said the new system "could revolutionize VA care but it is not on the right track today." Bost called on VA to "fix the process, strategy, and management challenges that led to those problems before moving forward anywhere else."

The next go-live is set for Columbus, Ohio, a site selected in the later stages of project development because of its current use of the Cerner scheduling module. According to the VA announcement, the order of subsequent go-live sites could be altered as a result of the review.

"It is more important for VA to get [Electronic Health Records Modernization] right than to rush it and put veterans' health at risk," Rep. Mark Takano (D-Calif.), the chairman of the House Veterans Affairs Committee, said in a statement. "This strategic review comes at a critical time, and I'm hopeful that it will ensure Secretary McDonough has an opportunity to examine the prior administration’s handling of the project and course correct if necessary."

The system was supposed to go live in March 2020, but multiple, overlapping delays caused by software integration problems, workplace restrictions and other issues related to the COVID-19 pandemic pushed the launch of the new system to October 2020.

The $16 billion price tag for the project includes $10 billion in a 10-year software contract with Cerner and $6 billion in planned infrastructure and hardware upgrade costs. The program is designed to replace VA's homegrown VistA EHR system, which was popular with clinicians but had evolved into more than 130 independent versions that presented interoperability challenges within the VA and with medical records systems at the Department of Defense.

The review, according to the VA statement, will focus on workflow issues and improvements to the patient portal.

"Cerner supports the decision by the U.S. Department of Veterans Affairs to conduct a strategic program review,” Brian Sandager, general manager of Cerner Government Services, said in an emailed statement. "Our number one priority remains the veterans we serve and delivering solutions that drive the transformation of care across the VA."