The Department of Veterans Affairs is reviewing the $16 billion contract for its electronic health records system, oversight that could halt the troubled rollout of the system to VA facilities, Secretary Denis McDonough said Wednesday.
At issue is the VA's Millennium Electronic Health Records program, built by Oracle Cerner. The system has been introduced at several sites, but continued expansion has been paused as the company works to solve ongoing problems with it that include stoppages, user difficulties and harm to patients.
During a hearing on the VA budget before a House Appropriations subcommittee, McDonough said the next system deployment, expected this summer in Saginaw, Michigan, will largely depend on the contract review.
"Depending on what happens in the contract, we will be able to deploy to the next site," McDonough said. "Increasingly, my question is I want to see what's in this contract because this contract may not be what we need."
The VA signed a $10 billion deal with Cerner in May 2018 to develop and oversee adoption of an electronic health records system that would be compatible with the Department of Defense, providing a single digital medical record for service members from the moment they are sworn in until death.
The DoD has introduced its version, called MHS Genesis, to more than 60% of military health facilities. About 10,000 employees use the system in five VA medical centers.
McDonough said that a review of the Oracle Cerner contract was built into its original terms.
"Inherent in the idea that there is a five-year review; you are not just reviewing it to continue it," McDonough said. "We would be in a position to sustain what we have and see if there's another technology."
Officials with Oracle testified before Congress earlier this month that improvements have been made and the system is ready.
Oracle Executive Vice President Mike Sicilia said that, given the work that was completed and a significant reduction in the number of times the system went down this year -- from an average monthly downtime of 345 minutes last year to 21 minutes each month this year, he is "more optimistic than ever" that the project is "on the right trajectory."
Lawmakers, however, have been skeptical, given the problems and rising costs.
"I have heard from providers who are burnt out trying to navigate this broken interface on top of what has already been an incredibly trying time for health care workers. I have heard directly from my constituents who have received a late cancer diagnosis because of the flaws in this system," Sen. Patty Murray, D-Wash., said during a hearing earlier this month. "None of this is OK."
House lawmakers have introduced bills aimed to improve or abandon the system altogether. A bill introduced by Rep. Mike Bost, R-Ill., would prevent rollout of the system at future sites without approval from senior physicians at the facilities.
And Rep. Matt Rosendale, R-Mont., has proposed scrapping the program altogether if improvements don't come.
During a hearing in early March, Daniel McCune, executive director for enterprise portfolio management at the VA, reiterated the department's commitment to the Oracle Cerner system, saying the VA did not "have a Plan B."
“All of our resources, both our people and our funding, are allocated to a successful Cerner implementation," he said.
– Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime