On Monday, Rep. Mike Takano, D-Calif., ranking member of the House Committee on Veterans' Affairs, and the committee's Chairman Mike Bost, R-Ill., introduced companion legislation to the EHR Program RESET Act of 2023 that had been offered by Sens. Jon Tester, D-Mont., Patty Murray, D-Wash., and Sherrod Brown, D-Ohio, on March 30.

They have introduced H.R. 2809 – which follows a series of related House bills to curtail or terminate the VA's beleaguered electronic health records modernization effort in partnership with Oracle Cerner – to begin negotiations between the Congressional chambers to address the management and delivery of the EHRM program.

"This bill will provide a framework for fixing the EHRM program and ensuring that VA fixes problems where the new health records system is in use before any new deployments," Takano said of the "troubled IT program" in the committee's announcement about the legislative action.

The new legislation includes the bill language for Takano's H.R. 1659, Department of Veterans Affairs IT Modernization Improvement Act of 2023, requiring the VA to contract for independent verification and validation for the EHRM and other modernization programs, and Bost's H.R. 592, Department of Veterans Affairs Electronic Health Record Modernization Improvement Act.

Meanwhile, the VA announced on Friday that it has halted the rollout to focus on optimizing the EHR at the sites where it is currently in use: Spokane VA Health Care System, VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care and VA Central Ohio Health Care System.

"Additional deployments will not be scheduled until VA is confident that the new EHR is highly functioning at current sites and ready to deliver for Veterans and VA clinicians at future sites," according to the agency's statement. 

"This readiness will be demonstrated by clear improvements in the clinician and veteran experience; sustained high performance and high reliability of the system itself; improved levels of productivity at the sites where the EHR is in use and more. When these criteria have been met and the reset period concludes, VA will release a new deployment schedule and re-start deployment activities."

One exception "to the full-stop on deployment activities" is at the only fully integrated VA and Department of Defense health system – the Captain James A. Lovell Federal Health Care Center in Chicago – where the new EHR is scheduled to go-live in March 2024.

Deployment at this facility will continue as planned in partnership with DoD and the Federal Electronic Health Record Modernization Office, according to the VA's announcement.

Takano and Bost's new bipartisan bill requires the VA and Oracle Cerner to meet or exceed performance baselines as determined by the Office of Information and Technology and the Veterans Health Administration for the five sites within 180 days after enactment of the legislation – or terminate their contract and come up with an alternative plan.

The bill, if passed, would also:

• Establish a program management office within the VHA, and reorganize management to include the reporting structure for the functional champion and deputy CIO.
• Restrict monetization or selling of veterans’ data by any internal or external entity conducting work for, with, or on behalf of the VA.

Bost added, "While I am encouraged that [VA Secretary Denis McDonough] has finally recognized the gravity of the situation and begun moving VA in the right direction, Congress has a duty to make sure any solution is comprehensive and bipartisan."

THE LARGER TREND

Dozens of slowdowns and outages since the VA's first EHRM go-live in October 2020 at Mann Grandstaff Medical Center in Spokane, Washington, and the EHR's failure to deliver more than 11,000 orders for requested clinical services, were followed by a series of VA Office of Inspector General reports.

The OIG found underestimated costs, training deficiencies, 149 instances of patient harm and other issues and raised alarm bells with legislators

Congresswoman Cathy McMorris Rodgers, R-Wash., said she was appalled in a July 2022 statement:

"Not only were 149 veterans in Eastern Washington harmed by the broken electronic health record system, VA and Oracle Cerner leadership downplayed the severity of the issue of the unknown queue, failed to adequately train providers on site and manipulated data to support a non-factual narrative about general system training and user proficiency."

On Tuesday, McMorris Rodgers issued a new statement reiterating her position and support for the Department of Veterans Affairs Electronic Health Record Modernization Termination Act introduced by Rep. Matt Rosendale, R-Mont., in February.

"I have long supported the goal of modernizing our health record system to better care for our nation’s heroes," McMorris Rodgers said. 

"Unfortunately, despite billions of dollars and every possible opportunity for improvement, it’s become abundantly clear that there is no coming back from the mess the Department of Veterans Affairs has made with this deeply broken system. It’s time to pull the plug."

ON THE RECORD

"We’ve heard from Veterans and VA clinicians that the new electronic health record is not meeting expectations – and we’re holding Oracle Cerner and ourselves accountable to get this right," McDonough said in the VA's announcement. 

"This reset period will allow us to focus on fixing what’s wrong, listening to those we serve and laying the foundation for a modern electronic health record that delivers for veterans and clinicians."