The Department of Veterans Affairs (VA) pulls on the parking brake for Oracle Cerner, but doesn’t turn off the engine. Last Friday (21 April), the VA formally announced ) that it would cease further deployments of the Oracle Cerner EHR until they can “prioritize improvements at the five sites that currently use the new EHR, as part of a larger program reset.” They have pledged to fix the issues that were identified during the “assess and address” review that started in late summer and fall 2022. No date was given on a restart which would come after which is presumably the ‘address’ part of the process.
In the release, VA will be redirecting resources to “focus on optimizing” Oracle Cerner where it is currently rolled out: Spokane VA Health Care System (Mann-Grandstaff), VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care, and VA Central Ohio Health Care System. The only exception is the deployment at the Captain James A. Lovell Federal Health Care Center in Chicago – which is the only fully-integrated VA and Department of Defense (Military Health System) healthcare system. That will proceed with a go-live of March 2024.
FedScoop reported that in a live briefing call with reporters, Dr. Neil Evans, who is the acting program executive director for the EHR Modernization (EHRM) Integration Office, would not give specific details about the contract negotiations with Oracle Cerner. “The original contract was a five-year base period with a five-year option, but everything has been on the table as part of the contract negotiations. I anticipate we’ll be able to share more as we near the end of those negotiations.” and “We are working towards an amended contract that will hold Oracle Cerner accountable to delivering the high-functioning, high-reliability EHR system that veterans deserve and will lay the groundwork for our expectations around improvements to the system that we think are necessary.”
The release also revealed a little surprise: “VA estimates FY 2023 costs will be reduced by $400 million.” This Editor noted last week that the March Senate VA Committee disclosed that the VA paid Oracle Cerner $4.4 billion on the contract to date, with a refund of $325,000 paid as compensation for ‘incomplete technology and poor training’. Obligations through the contract were $9.4 billion. The VA will be working with Congress on resource requirements.
Speaking of Congress, the House has now proposed a fourth bill, H.R. 2809, requiring the VA to reform the EHRM program. This bill takes the ‘hold rollout till issues’ position versus “pull the plug” (H.R. 608, which hasn’t moved out of subcommittee). This would require:
- establishment of program management within the Veterans Health Administration
- reorganizing the management of the current reporting structure for the EHR functional champion and deputy CIO
- restricting the monetization or selling of veterans’ data by any internal or external entity conducting work for the VA
- requiring that performance baselines are met or exceeded at the five live sites before it goes live in other systems
Unlike the VA release, there’s a time limit and a kicker. 180 days after legislation enactment, if VA and Oracle Cerner cannot meet the requirements for the five sites, the bill directs VA to consider terminating or canceling the contract. ‘Consider’ is a bit of a weasel word, but is probably as far as the House wants to go. Another difference is that it is bipartisan, proposed by Democrat Mike Takano of California with six other Democrat House members but with the co-sponsorship of three Republicans, including Rep. Mike Bost of Illinois who is the chairman of the House Committee on Veterans’ Affairs which will review the bill. TTA’s most recent coverage of VA’s troubles with Oracle Cerner: 19 April, 20 April
And yet another outage. On 25 April, the Oracle Cerner EHR was unusable for at least five hours. It affected Spokane, Wash.-based Mann-Grandstaff VA Medical Center, Fairchild Air Force Base, and military hospitals across the country, which means it affected VA and MHS where it has largely replaced AHLTA. The Spokane Spokesman-Review obtained an email from Mann-Grandstaff Director Robert Fischer confirming the outage Tuesday while it was happening. Dr. Feinberg, the Cerner integration is going great, right? Fixing this should be Job#1. Becker’s HealthIT