House appropriates $1.9B for Oracle Cerner VA EHR modernization, $5.2B for telehealth, plus other technologies; Oracle lays off more Cerner staff

House appropriations for the VA in FY 2024 were passed last week, including requirements for the VA/Oracle Cerner EHR Modernization program. The House allocated $1.9 billion in total for VA’s Oracle Cerner EHRM program. According to the report in FedScoop, the topline amount is broken down as follows: $1.2 billion for the Oracle Cerner-operated contract, $424 million for infrastructure readiness, and $253 million for program management. 

The budget is part of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill 2024 (full bill). The bill goes to the Senate after the summer recess. See pages 53 and 54 for the EHRM.

Key points:

  • This appropriation is the sole source of funding for the EHR modernization program. “No authority is provided for funds from other VA accounts to be transferred into this account nor for funds from this account to be transferred out to other accounts.”
  • Reaffirms “quarterly reporting of obligations, expenditures, and deployment schedule by facility and the Office of Deputy Secretary to administer the initiative”
  • There is also a 25% contingency upon the VA Secretary to report any outstanding issues impacting the stability and usability of the system, certifying and detailing any changes to the deployment timeline, certifying the status of outstanding issues, and whether
    the system is ready and optimized for further deployment at VA sites. 
  • ” The Government Accountability Office is directed to continue quarterly performance reviews of EHRM deployment and to report to the Committees each quarter.”

Reports will start within 30 days of the enactment of the appropriations bill looking back on “each new requirement and customized interface added in fiscal years 2022 and 2023, including the cost of each, reasons for inclusion, and whether they were outside of the scope of the contract within 30 days of enactment of this Act.” At 45 days, the bill requires a briefing on how the Department plans to set enterprise standards. The bill also confirms that no new deployments are scheduled for FY2024 and the 25% of funds set aside for FY2023 in deployment will not be released. Also EHR Intelligence

The bill also allocates $5.2 billion for telehealth and connected care (page 42). This covers services in home telehealth, home telehealth prosthetics, and clinic-based telehealth. The bill encourages expanding telehealth capacity to address backlogs for disability exams and healthcare appointments when appropriate. Our top story on 9 June was the award of Home Telehealth monitoring contracts to incumbent Medtronic and newcomers Cognosante, Valor Healthcare, and DrKumo.

Included in other budget lines are healthcare technologies (pages 33-34) such as bioelectronic medicine/AI, early detection diagostics, focused ultrasound therapy, medical image exchange, migraine prevention and treatment, and respiratory illness diagnostics using 4-dimensional images of lung function. 

Meanwhile, Oracle is laying off more Cerner employees. Your Editor is basing this on a Reddit 1 August thread that has no totals but indicates that employees were told yesterday (1 August), given two weeks notice to 15 August, and that the layoffs hit areas such as revenue cycle, 10% of CernerWorks, and properties. CernerWorks hosts, manages, and monitors client systems by providing data center hosting services for Cerner EHRs and other SaaS. Whether any of this affects the VA is to be determined, but their Federal service area had 500 to a rumored 1,200 layoffs in June. This was not much of a surprise with the near-completion of the DOD Military Health System EHR implementation and the holdup save one of the VA’s implementations (except the joint VA-MHS Lovell facility in Chicago). Our Readers have heard this here first.

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