The announcement comes just a week after VA Secretary Denis McDonough scrapped the previous rollout schedule for the department’s adoption of the Cerner Millennium records platform, which had called for the system to be put into use at the Columbus, Ohio, VA medical center later this summer and at all department medical facilities by the end of 2028.
An internal investigation by VA officials called for the changes after they uncovered widespread training and management programs with the $16-billion records overhaul project at its first implementation site in Spokane, Washington last fall.
The new timeline for the 10-year, $16-billion project has not yet been settled.
In addition, the VA Inspector General in a separate report characterized that rollout as a mess, “insufficient time for training … challenges with user role assignments, and gaps in training support.”
On Wednesday, in testimony before the House Veterans’ Affairs Committee, Assistant Under Secretary for Health Carolyn Clancy acknowledged “there was also a clear lack of testing and training that mirrored real-life clinical environments” with the initial deployment.
VA officials have insisted the problems are not with the software itself, but instead with the preparation and training work involved with putting the new system in place.
“We’re building a system that helps providers understand each veteran’s unique story and wrap around them the resources of our nationally integrated system,” she said. “That’s the end goal. We can get there.”
The decision to use the Cerner software for VA came in 2017 under then-President Donald Trump, with the idea of putting veterans medical records and DOD health care systems on the same platform for the first time.
But the cost and scope of the problem has been met with skepticism since. On Wednesday, Brian Sandager, general manager of Cerner Government Services, acknowledged that “we have not done a good enough job articulating to [VA staff] why this transformation is so important for the veterans.”
Company officials acknowledged that early testing was focused more on technical issues than ease-of-use for staff. They have promised to work closely with VA leaders on fixes to that in the month ahead.
But that did not calm some lawmakers’ doubts about the project.
“Billions of taxpayers dollars are on the line, and the numbers seem to be going up each and every day,” said Rep. Matt Rosendale, R-Mont. “If [officials] cannot make headway with the situation in Spokane, then the reason is probably pretty simple: The software just isn’t any good, or isn’t good for the VA.”
At Wednesday’s hearing, Rep. Frank Mrvan, D-Ind., announced he and the committee’s leaders (Chairman Mark Takano, D-Calif., and ranking member Mike Bost, R-Ill.) introduced new legislation which would mandate a full financial accounting of the electronic health records project so far.
“You can’t put a modern electronic health record on an aging IT infrastructure, and you can’t update IT infrastructure in an aging VA facility without making improvements,” Mrvan said. “These issues must be addressed and costs must be accounted for as part of the project.”
GAO officials said work should halt until fixes are in place, but VA officials said they can make corrections without delaying any deployment plans.
VA leaders said they are already working on that, and have promised full transparency on the cost following incomplete reports from the previous administration.
Cerner and department officials are planning a “technical-only” deployment of the new technology at the Spokane and Columbus sites later this summer, but have promised no impact on patients or clinicians.
McDonough has also said officials will abandon previous plans for a site-by-site scheduled deployment of the new system, instead evaluating individual facilities preparations and readiness before putting the new system in place.
VA leaders are expected to announce what those sites may be in the next few months.