Chairman Jon Tester, D-Mont., and his Senate Veterans’ Affairs Committee colleagues Sens. Patty Murray, D-Wash., and Sherrod Brown, D-Ohio, are planning to introduce legislation in the coming days that would increase oversight of the Department of Veterans Affairs (VA) Electronic Health Record Modernization (EHRM) program, order technical fixes to current problems with the system, and leave room for the agency to pursue alternative tech strategies if need be.
The EHR Program RESET Act aims to restructure and enhance the EHRM program, while also mandating frequent reporting to Congress to increase oversight, accountability, and transparency. This legislation is the latest effort to improve the EHRM program, following well-publicized challenges with the program and its Oracle Cerner system.
“It’s clear that the new EHR system is failing veterans, medical personnel, and taxpayers, and we need aggressive measures to right this ship and get a better return on investment through this contract,” Sen. Tester said in a press release.
“That’s why my colleagues and I are putting forth comprehensive legislation to increase transparency and oversight over the new electronic health record system – holding VA and Oracle Cerner accountable on behalf of the men and women who risked their lives to defend our country,” he added. “Veterans deserve nothing less, and I won’t back down from our continued commitment to safely deliver them the health care they need and earned.”
Among its many provisions, the senators’ legislation would require the VA to develop clear metrics to guide “whether and how” the agency should deploy the EHR system at other VA facilities.
Additionally, it would require the VA and Oracle Cerner to fix the technology features related to patient safety and delivery issues, as outlined in the recent report from the VA’s EHRM Sprint Project Team.
The VA made the decision last October to delay further deployments of its Oracle Cerner EHR system until June 2023. The purpose of this pause was to “assess and address” concerns with the system, performance, and functionality for veterans and VA healthcare personnel.
However, the legislation would instruct the VA to not move forward with other EHRM deployments at other VA sites until the data at the five existing deployment sites “demonstrates an ability to deliver health care to veterans at standards that surpass metrics using VA’s VistA system or that meet national health operations standards as determined by the under secretary for health.”
The VA acquired Oracle Cerner’s Millennium EHR platform in 2018, and the Federal contract for the program’s work in coming years is set to be renewed in May. In light of that, the bill would also appoint a lead senior negotiator, as well as leverage other Federal agencies and outside experts to offer advice and strategies “for managing aggressive EHR contract negotiations with Oracle Cerner to protect taxpayers and veterans.”
As several lawmakers have asked the VA to pull the plug on the Oracle Cerner contract and consider a “Plan B” strategy, the bill also would require the VA to develop an alternate strategy for a new EHR. This alternate strategy would be used in the event that Oracle Cerner’s new contract terms fail to “protect taxpayers and increase accountability and penalties for poor performance or when VA data shows it cannot get the technology to work to serve veterans efficiently and safely,” the press release says.
The bill will also call on the VA to “reform major acquisitions” to prevent future program missteps, and requires an existing VA Advisory Committee to add healthcare experts with experience in implementing EHR deployments to advise VA leadership “on potential strategies on how to improve VA EHRM’s implementation based on prior lessons learned in the private and non-profit health sectors.”
Finally, the legislation calls on the Department of Defense (DoD) to report to Congress quarterly on steps it’s taking to fix DoD IT systems, including those that might negatively impact VA’s ability to deliver. The DoD acquired Oracle Cerner’s EHR system in 2015 – about three years before the VA – and is on track to complete its deployment efforts by the end of this year.
“I have been clear from the start – VA cannot continue with its current EHR system until it works for providers and keeps patients safe. This legislation will put into law the kind of aggressive oversight necessary to fix the current system – that’s my first priority,” said Sen. Murray.
“Importantly, this set of reforms will also overhaul the contracts and acquisitions process so that the issues we’ve seen these last few years can be prevented in the future,” she continued. “I want to make sure the dedicated providers at VA can do their jobs and that our veterans are getting the high-quality care they have earned and deserve. Let’s pass the EHR Program RESET Act as soon as possible.”