The U.S. Department of Veterans Affairs has awarded the second option period for its electronic health record modernization contract with Oracle Health. It's an 11-month extension, "with an emphasis on improved fiscal and performance accountability," according to the VA.

WHY IT MATTERS
The agency says it is keenly focused on making the new extension count, with the expectation that Oracle will achieve "two main objectives" for the problem-plagued EHR program:

• Supporting value-added services such as system improvements and optimizations.

• Achieving better predictability in hosting, deployment and sustainment, while keeping an eye on fiscal responsibility. 

"These objectives align with and facilitate VA’s reset efforts towards resuming site deployments in fiscal year 2025," officials said. "VA will continue to evaluate and align future option periods with the best path forward for its Federal EHR modernization."

The new option period represents a continuation of VA's work to improve the Federal EHR for vets. The six VA healthcare facilities already live on the new system, the agency noted. The contract will also enable new pre-deployment and deployment efforts at new sites in FY25, "once VA determines reset goals have been met."

In 2023, the VA renegotiated its Oracle Health contract from a five-year term to five one-year terms – which enables a more regular annual review of the program's progress. That has "substantially increased accountability across a variety of key areas," the agency says, "including minimizing outages and incidents, resolving clinician requests, improving interoperability with other health care systems, and increasing interoperability with other applications."

In a brief press release of its own, Oracle Health said the new contract extension is a "testament to the progress Oracle and VA have made" on the EHR modernization, which has seen no shortage of challenges and setbacks in recent years.

"Our most recent roll-out at the Captain James A. Lovell Federal Health Care Center in North Chicago, IL exceeded expectations and demonstrated what's possible as we move ahead with other VA facilities," said Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences, in a statement.

Oracle Health said it is focused on helping VA standardize workflows, training and IT management nationwide, and enabling more streamlined coordination and interoperability with the DOD, the Coast Guard and other federal agencies. The company is also prioritizing flexibility to help VA sites adopt new tools that will improve usability and safety of its EHR system.

THE LARGER TREND
The VA first announced its deal with Cerner to replace the aging VistA system seven years ago this month – whereupon then-President Donald Trump promised the new EHR would solve nationwide data exchange issues for the agency "once and for all."

Since, then however, the rollout of the system, starting with facilities in Washington State, has been challenging, to say the least – even if there have been some useful lessons learned along the way.

As far back as early 2021, the agency was already performing a strategic review of the modernization program following rollout challenges, missed deadlines and other delays.

Since then there have been several reports from the VA OIG that have shown instances where the system had contributed to patient harm.

After a pause to reset and recalibrate the rollout in 2023, it was announced this April that the rollout would resume in 2025.

Still, recent OIG reports continue to show significant and dangerous configuration challenges with the EHR.

And just this month, Bloomberg reported on an internal survey at the VA that found widespread clinician dissatisfaction with the system..

"There is a trend toward improvement, however most users still indicate a negative experience," wrote VA researchers in the unpublished report.

These and many other issues have attracted the close scrutiny of members of Congress – many of whom continue to call for much stricter oversight of the VA's $16 billion contract with Oracle Health.

ON THE RECORD
"This announcement is a testament to VA’s commitment to keeping the best interests of Veterans, VA providers, and taxpayers at the forefront while maximizing resources in a fiscally restrained environment," said VA Deputy Secretary Tanya Bradsher in a June 13 statement announcing the Oracle renewal.

"Executing the second option period of the contract allows VA and Oracle Health to continue to drive forward on the goals of the reset and future deployments," she said. "VA remains committed to holding ourselves and our vendors accountable for resolving challenges with deployment of the Federal EHR and moving forward productively."

"VA's intent to resume deployments in the next fiscal year is a significant milestone that reflects the hard work our collective teams have done to improve the system today, as well as confidence in our shared ability to continually evolve the EHR over time to meet the needs of both practitioners and patients," added Verma.

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.