The VA’s EHR modernization (EHRM) plans may be hearing screeching brakes or a swerve if this bill sees daylight. Last week’s House Committee on Veterans’ Affairs reviewed 27 bills plus five discussion drafts as part of its sweeping reauthorization initiative to review, improve, and reauthorize specific programs and sectors at the Department of Veterans Affairs (VA). Many of these programs haven’t been reauthorized by Congress in three decades. House VA Committee release 18 March
A two-year leash. Of most interest re the EHRM plans is the 33-page discussion draft (PDF) of a bill proposed by Rep. Nikki Budzinski (D-IL), “To provide for the modernization of the electronic health record system and other health information technology activities and systems of the Department of Veterans Affairs, and for other purposes.” It specifies a series of reports from the VA Secretary that constitute ‘guardrails’ on the EHR implementation–a noun used extensively by both Chairman Bost and member Budzinski. At the 18 March meeting, according to FedScoop, Rep. Budzinski’s proposed bill would require the VA to “create a baseline of clinical and business workflows, as well as technical requirements, to ensure the standardization of VA practices and systems.” It would also set new “health care quality metrics” based on the VA’s own Strategic Analytics for Improvement and Learning Value Model, and new reporting and independent verification and validation requirements.” If the bill becomes law, the VA secretary has two years to certify that the system’s requisite baselines and metrics “show consistent improvement” and that at least two VA facilities implement the Oracle EHR with the certifications in place. What this bill does introduce is to prevent any renewal or options for the Oracle contract if the requirements aren’t met.
The question that this Editor would pose to Rep. Budzinski is: isn’t this bill and its requirements coming a little late in the day? 13 health system EHR rollouts are already planned, starting in April for the year, announced in February by the EHR Modernization Integration Office (EHRM-IO) [TTA 8 Feb]. The VA stopped Oracle EHR rollouts in 2023 save for Lovell in Chicago. Since then, the original six disastrous installs have been overhauled and tested. There have been multiple hearings, floggings of Oracle executives, and extensive reports from the VA’s Inspector General. What does this bill add to the mix, and do these ‘guardrails’ add meaningfully to performance.
The Committee chair, Rep. Mike Bost (R-IL), reportedly wants to use an NDAA-style process (named after the National Defense Authorization Act) to unify the bills into one ‘must-pass’ legislative bill. One can expect that some of the bill’s language will be written into the final bill, but it will be, in true House fashion, picked over and simplified from the elaborate language in the draft.
Yet another factor. By end of month, the rumored 20-30% Oracle layoffs, outlined with some specificity on boards such as Reddit, will undoubtedly hit Oracle Health hard. Oracle has a contract, governmental, and regulatory obligation with the VA. Despite that, the rumors also say that even those areas will be hit, perhaps less hard, but still reduced in size–sacrificed for the financial obligations tied into the New Shiny Object, datacenters. [TTA 6 March, 10 March] This is also despite Oracle’s strong Q3 showing which didn’t break out Oracle Health. Something has to give, and it’s politely called ‘restructuring’.
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