More than 18 months after the Veterans Administration paused new deployments of its Oracle electronic health record system to make critical improvements to the EHR and improve patient safety at five VA health systems, the agency announced Friday that it has improved veteran trust and clinician satisfaction. 

It's been more than 200 days since the last outage, the VA said. 

WHY IT MATTERS

The agency said that during its EHR modernization program's reset period, it reviewed errors and worked with Oracle officials on hundreds of system improvements, updated contracts to hold the company accountable – which included monetary credits for failing to meet key performance accountability metrics – and instituted a new process to address system concerns when they arise.

As a result of its efforts, the agency is ready to begin planning for new 2026 deployments, VA Deputy Secretary Tanya Bradsher said in a statement.

Veteran outpatient trust scores have increased at all VA sites running the Oracle Health EHR since the beginning of the EHR modernization reset period, according to the agency.

In April 2023, VA Secretary Denis McDonough announced a "full-stop on all planned deployments" of the Oracle Health EHR to focus on fixing issues identified at five sites using it – 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.

Comparing results of direct veteran surveys administered in the first quarter of last year, the VA said veteran outpatient trust scores increased at all EHR sites.

The scores reached 93% at Columbus VA, part of the Central Ohio Healthcare System, representing an 11.6% increase; 88% at Walla Walla VA with a 4% increase; 92% at Mann-Grandstaff VA in Spokane, Wash., with a 3.5% increase; 85% at Roseburg, with a 5.2% increase; and 89% at White City VA, part of the VA Southern Oregon Healthcare System, with a 6.5% increase.

The VA also said EHR outages have significantly decreased with the system functioning 100% of the time for 10 of the last 16 months and 99.8% the rest of the time. Of note, the agency said that there the average daily EHR user now experiences zero system interruptions – which it said represents minimized care delays for veterans.

While veteran outpatient trust scores at the Captain James A. Lovell Federal Healthcare Center in Chicago showed a marginal increase, from 90.2% to 90.8%, the agency called the Oracle Health EHR launch earlier this year a success that outperformed all five of the previous rollouts. 

The integrated VA and Department of Defense health system was one planned exception to the beleaguered EHR modernization program's pause.

With the new EHR, the VA's Chicago health system rapidly increased productivity, the VA said in the announcement. 

THE LARGER TREND 

In April, McDonough told the House VA Committee in an update on the program reset that he anticipated having discussions before the end of the year about scheduling go-lives in 2025. 

Then in September, the VA's Office of Inspector General said it determined that the VA and Oracle Health had been misaligned in their responses to system outages. 

In its audit report, the watchdog agency cited a lack of consistent response standards and weaknesses in several controls regulating configuration management and monitoring. OIG said action is still needed to prevent some EHR outages and mitigate risks to veterans in the VA's care.

In November, President-elect Donald J. Trump nominated former Rep. Doug Collins, a Republican from Georgia, to serve as his administration's VA Secretary. 

"We'll fight tirelessly to streamline and cut regulations in the VA, root out corruption and ensure every veteran receives the benefits they've earned," Collins said on social media. "Together, we'll make the VA work for those who fought for us."

ON THE RECORD

"We paused deployments of the EHR for more than a year and a half to listen to veterans and clinicians, understand the issues and make improvements to the system," Bradsher said in a statement. "As a result of those efforts, veteran trust and system performance have improved across the board."

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