The Department of Veterans Affairs' new electronic health record system experienced the second outage in eight days on Tuesday, a setback VA Secretary Denis McDonough called "extraordinarily frustrating."
The 224-minute outage of the Oracle Cerner system, during which health care providers could not utilize it, affected the five medical centers and affiliated clinics that have started using the system at the VA -- as well as all Defense Department and Coast Guard health facilities also using the software, according to VA officials.
The event occurred just days after the VA announced it had halted expansion of the program to additional facilities until all system problems are addressed.
According to VA spokesman Gary Kunich, the outage began when "one of the databases in the Federal [Electronic Health Record, or EHR] became unresponsive due to a failed background process."
Normally, Kunich said, other databases would compensate but weren't able to do so, "resulting in the entire database cluster to be restarted." Recovery took more time than expected when administrators tried to reboot the system.
"The root cause(s) underlying this incident remain under investigation," Kunich said in a statement to Military.com on Friday.
The outage was first reported by the Spokesman-Review in Spokane, Washington.
The VA signed a $10 billion contract with Cerner in May 2018 to develop and introduce an electronic medical record system compatible with the DoD's -- an effort to provide lifelong medical records tracking for service members.
The cost estimate for the VA system has risen to $16.1 billion over 10 years; the Institute for Defense Analyses recently estimated that the system could cost up to $38.9 billion over 13 years.
Lawmakers have demanded that the system be fixed before the program is expanded to all 171 hospital systems in the Veterans Health Administration, while some have called for it to be completely scrapped.
Rep. Matt Rosendale, R-Mont., has introduced legislation that would end the program if improvements aren't made.
On Tuesday, amid the outage, Rep. Cathy McMorris Rodgers, R-Wash., whose district includes the facility where the EHR was first introduced, Mann-Grandstaff VA Medical Center and its affiliated clinics in Spokane, called for its termination.
"The Oracle Cerner electronic health record system has been a complete failure. It has caused serious harm to patients, devastated morale amongst employees and providers, and created a crisis of confidence for veterans," McMorris Rodgers said in a statement. "It's time to pull the plug."
McDonough acknowledged the outages to a Senate Appropriations subcommittee on Wednesday, saying that, although there was a seven-month lull in outages, it did not mean that "across the system it was functioning perfectly even."
"I am extraordinarily frustrated with this. I know our providers and our veterans in Washington and in Oregon and in Ohio are extraordinarily frustrated with this," McDonough told members of the Senate Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies.
"The whole point of this assessment -- or this whole point of this reset -- is to clear away everything else. Let's focus on the five. Let's get it right. And then, we'll talk about onward deployment," McDonough said.
Subcommittee Chairwoman Sen. Patty Murray, D-Wash, who has often been critical of the rollout, called the system an "ongoing disaster" and said the indefinite pause in rollouts is necessary.
"I've raised concerns for my constituents in Spokane and Walla Walla about the usability and reliability of the system and some very serious patient safety concerns," Murray said. "I do support efforts to move forward, only after you are confident about the safety and effectiveness of the system."
The VA currently is in contract negotiations with Oracle Cerner for what was originally slated to be a five-year option to renew the program. That process is expected to be complete by May 16, but whether it will be for another five years remains to be seen.
The VA has requested $1.9 billion in its fiscal 2024 budget for the continued rollout of the Oracle Cerner system. McDonough told Murray that the reset has resulted in the VA receiving $400 million more in fiscal 2023 than it needed and will affect the fiscal 2024 request.
"We'll want to work through with you the specifics on the FY '24 request. But the bottom line is I think it stands to reason that that request will look different," McDonough said.
As part of her announcement regarding the Oracle Cerner system, McMorris Rodgers threw her support behind Rosendale's bill, the Electronic Health Record Modernization Act, H.R. 609.
"We need to go back to a system that works immediately and deliver on our promise to give veterans in eastern Washington the best care our country has to offer," McMorris Rodgers said.
– Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime.