Denis McDonough, secretary of the U.S. Department of Veterans Affairs, told the House VA Committee on Thursday that progress on the EHR Program RESET Act of 2023 – first introduced a year ago – will help address some of the challenges of the Oracle Health electronic health record rollout, and enable wider implementations in 2025. 

WHY IT MATTERS

While the four-hour Congressional session covered numerous budgetary requests by the VA, legislators asked about some health IT specifics – such as funding to continue the agency's EHR modernization program, infrastructure readiness and more.

"VA is seeing incremental, but accelerating progress as it addresses the issues that clinicians and other end users are experiencing and as it optimizes the current state of the EHR system to ensure the enterprise-wide foundation is in place for success when deployments resume," said McDonough said in a statement on the U.S. Department of Veterans Affairs Budget Request for Fiscal Years 2025 and 2026.

The Biden Administration made the VA EHRM one of its national healthcare priorities last year, proposing $1.9 billion to support the project. 

In March, the signed 2024 Military Construction, Veterans Affairs and Related Agencies Appropriations Act ultimately allocated $1.3 billion for the VA EHRM, but authorized Congress to withhold 25% based on efforts to remediate past issues, NextGov reported.

In the past, some lawmakers wanted to end the plagued Oracle Cerner rollout, which drove further Congressional scrutiny over pledged funding.

McDonough confirmed Thursday that the FY25 budget of $894 million supports the Oracle reset and funding of the six VA sites that currently use the new EHR. 

During questions, Rep. Sheila Cherfilus-McCormick, D-Fla., said that she was concerned that a dramatic budget cut – half the budget of FY24 – would compromise the VA's ability to move beyond the program reset to implementation, and also asked about future go-lives at additional VA healthcare sites next year.

"We're not staying in reset forever," McDonough responded, saying that he anticipates having discussions before the end of the year to move beyond the EHRM reset, and about scheduling go-lives in 2025. 

She asked him how they would be paid for, and he answered that they would be paid with three years of existing funding. 

McDonough also called the proposed budget for FY25 and FY26 VA a "maintenance budget," but stressed that a single health record – one that communicates with the Department of Defense's EHR – is needed across the VA health system.

THE LARGER TREND

Last year, the VA announced a renegotiated contract with Oracle that includes significant monetary credits to the agency if the vendor does not meet key performance-accountability metrics.

"The Oracle Cerner electronic health record program is deeply flawed – causing issues for medical staff and posing significant patient safety risks," Rep. Matt Rosendale, R-Mont., said in 2023 when he proposed legislation to put a stop to VA EHR modernization. 

Following a series of outages and incidents of patient harm, the VA's Office of Inspector General has conducted multiple investigations into potential system flaws. 

The agency recently completed one of the investigations – pharmacy-related patient-safety issues following report of a prescription backlog at the VA Central Ohio Healthcare System in Columbus, Ohio, that occurred after the Oracle EHR went live in April 2022.

OIG flagged active medication list issues in VA EHR in a statement to the House Veterans Committee's subcommittee on technology modernization at a February 15 hearing on the safety and efficacy of the beleaguered EHR.

The watchdog agency said that, if veterans have had treatment at one of five sites using the department’s Oracle Health EHR, and then follow up at a site on the legacy Vista EHR, their medication information may be incorrect.

OIG has provided the VA with more than 70 recommendations for corrective action since April 2020, David Case, deputy inspector general at OIG, said in a statement to the subcommittee.

ON THE RECORD

"VA acknowledges that an updated [VA EHRM] deployment schedule is critical to demonstrating commitment to and will provide that schedule to the committee once it has been determined," McDonough said in a statement to the House Veterans Affairs Committee.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.