VA's health record 'reset' will extend into 2024

The Department of Veterans Affairs is eying the summer of 2024 to resume its deployments of the Oracle-Cerner electronic health record system. 

The 10-year technology refresh, currently budgeted at $16 billion but widely expected to cost much more, was paused in April to focus on driving improvements at the five VA sites where the new record is currently in use.

At a Wednesday hearing of the House Appropriations subcommittee that funds VA, program head Neil Evans told lawmakers that the next deployment will take place at Lovell Federal Health Care Center in North Chicago in April 2024. This go-live was kept on the schedule despite the pause because it is taking place at a facility that also serves Defense Department patients. DOD is using the same commercial records system as VA, but it is very close to completing its full deployment. 

Assuming that go-live goes well and other program improvements are on pace, VA officials expect deployments to resume in the summer of 2024.

"VA has organized the work of this program reset into three-month increments and just completed its first increment on August 31," Evans said. "Initial efforts focused on making necessary system changes, improving the technical stability of the system, enhancing end user support and ticket management, addressing communications within VA and developing a larger cohort of VA experts who can support the new system in the years to come."

Oracle executive Mike Sicilia, who also testified at the hearing, said that the reset period includes 270 workflow reconfigurations designed to improve user experience and the efficiency of the system at the sites where the new electronic health record is currently in use.

"So, these are things that we're cleaning up, if you will, based on direct provider feedback from VA providers who have given feedback around a certain way the system functions," Sicilia said.

Sicilia also said he expects VA to develop a plan to support multiple, parallel deployments of the system, once these tech, training and configuration problems are resolved. He said he doesn't expect to add to the original $10 billion for the software called for in the 2018 contract. 

"And we can, to make it quite simple, deploy more than one site at a time. We don't have to be in a serial mode where you've got one site at a time," Sicilia said.

Sicilia also noted that the original training plan for VA users of the software may have been too all-encompassing rather than focusing on specific roles and responsibilities.

"I mean, very few people inside an organization like this will use the entirety of the system. They have a role. They're radiologists, they work in the ICU. They — they do something that's specific to their job," he said. "And I think some of the mistakes — and these are our mistakes, this is our job to fix — was that the training was too cumbersome."