Amid ongoing problems with the new Veterans Affairs electronic medical records system, lawmakers on Tuesday warned department officials against further expanding the program into larger sites until permanent solutions can be put in place.
“Given the issues that we’re seeing in Spokane and Walla Walla, I think the risks exceed the benefits,” said Rep. Frank Mrvan, D-Ind., chairman of the House Veterans’ Affairs Committee’s technology panel. “We have seen no indication that the system is ready for the challenges at [bigger] facilities.
“These issues have to be fixed first.”
Those issues for the 10-year, $16 billion health records modernization effort include multiple outages over the last six months, reports of a near-death at a Spokane VA medical center last month connected to the records turnover, and the potential of billions in cost overruns if the project is delayed even by a single year.
But VA officials insisted that the new records system — based on the Cerner Millennium software platform — is still fundamentally sound, and that new training put in place this spring has set up a more successful implementation of the software in years to come.
“This is one of the most complex clinical and business transformation endeavors in the department’s history,” said Dr. Terry Adirim, head of VA’s Electronic Health Record Modernization Integration Office.
“We are transitioning from the current nearly 40-year-old [records system] to a new single state-of-the-art system that requires a different way for personnel to do their work. I am sensitive to how hard this can be.”
Last year, VA leaders paused the system rollout for six months amid a host of problems at the first deployment site, Mann-Grandstaff VA Medical Center in Spokane. Last month, that work resumed, with new training for staff, new management for the program and a new deployment at nearby department sites in Walla Walla.
However, lawmakers on Tuesday said those changes have not erased their lingering concerns.
A report by the Spokesman Review this weekend detailed how one veteran’s medication history was halted because of the records turnover, eventually resulting in heart failure.
VA officials classified the incident as a mistake by staff, rather than an error prompted by the new records system.
“I don’t believe that there’s any evidence that this system has harmed any patients, or that it will going forward,” Adirim said. “I think it’s important that we have the processes in place to mitigate any problems that could come up due to human error.”
VA leaders also insist that the program is scheduled to be finished in six years, in keeping with the original 10-year schedule.
If not, it could mean a big financial expense for the government. An inspector general report released Monday said every additional year it takes to finish the project could cost $1.9 billion more above the project’s $16 billion price tag.
On Tuesday, representatives from the VA Inspector General’s office said serious concerns remain in how the project is being managed and rolled out.
“Staff have repeatedly found VA’s estimates unreliable and incomplete,” said David Case, deputy inspector general. “There is a lack of transparency due to inadequate reporting to Congress, stove-piped governance with decision-making … and deficient processes for transparently and promptly responding to concerns.”
But Adirim insisted that the system has already been “successfully implemented at more than 50% of the Department of Defense sites across the United States,” suggesting those lingering problems can be overcome.
When the project was first announced by President Donald Trump in 2017, the idea was to put the Defense Department and VA on the same health records system for the first time. That would provide a single medical file that followed individuals from military enlistment into post-service life.
Patrick Sargent, senior vice president of Cerner Government Services, called the project “a once-in-a-lifetime opportunity to fundamentally change healthcare for generations to come” during Tuesday’s hearing.
But lawmakers have voiced concerns about the cost and turmoil of reaching that goal.
“I realize that VA needs a modernized records system,” said veterans committee Chairman Mark Takano, D-Calif. " Continuing with [the old VA system] is not sustainable long term.
“However, we must make sure that we are not putting undue burden on our front-line workers or endangering veterans in the process.”
In advance of the hearing, the Cerner system went offline for several hours on both Monday and Tuesday, disrupting some care at the sites already using the new software.
VA officials plan to deploy the new system at sites in Columbus, Ohio, in coming days. VA has plans for further rollouts later in the year, but whether the objections by Congress on Tuesday will change that remains unclear.
Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.