VA Stops Rollout of Cerner EHR To Reset Amid Continued Problems

The painful paused and repaused rollout of the new Cerner electronic health record (EHR) system at the US Department of Veterans Affairs (VA) is now halted as the VA announces a “reset.” The decision applies to all planned deployments. An exception is the Captain James A. Lovell Federal Health Care Center in Chicago, the only fully integrated VA and US Department of Defense (DoD) health care system, which is expected go live in March 2024 as planned. The DoD rollout of its Cerner EHR is further along and expected to be completed in 2024.

The new plan is to redirect resources and “prioritize improvements” at the 5 sites currently using the new EHR: Spokane VA Health Care System, VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care, and VA Central Ohio Health Care System. Additional deployments will not be scheduled, the VA says, until it is confident that the new EHR is highly functioning at the current sites and ready to deliver at future sites, as demonstrated by “clear improvements” in the clinician and veteran experience, sustained high performance and high reliability.

“For the past few years, we’ve tried to fix this plane while flying it—and that hasn’t delivered the results that veterans or our staff deserve,” said Neil Evans, MD, acting program executive director at the Electronic Health Record Modernization Integration Office. “This reset changes that. We are going to take the time necessary to get this right for veterans and VA clinicians alike, and that means focusing our resources solely on improving the EHR at the sites where it is currently in use, and improving its fit for VA more broadly. In doing so, we will enhance the EHR for both current and future users, paving the way for successful future deployments.”  

The various EHR rollouts around the country have been bumpy from the beginning, operating by fits and starts as new problems surfaced and were addressed. To be fair, the whole implementation process only started in 2020 (and deployed at the first VA hospital during the COVID-19 pandemic), but in that time, the VA has had to, in its own words, “revise the timeline” again and again. The Boise VA Medical Center, for instance, was originally scheduled to go live June 25, 2022, then a month later—then 2023.

The VA Office of the Inspector General published 3 reports last year that found significant issues, including improperly routed clinical orders. VA Secretary Denis McDonough announced last July that the VA would delay EHR deployments until January 2023 to ensure that the system’s issues had been resolved. “During VA’s subsequent investigation at our current sites,” he said, “several additional technical and system issues were identified—including challenges with performance, such as latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders.”

In February, Ken Glueck, executive vice president of Oracle, wrote a blog post that was both apologia and explanation. Modernization, he said, “doesn’t come with a magic wand and there’s no easy button.”

After the DoD moved to Cerner for a new EHR system, the VA decided to follow suit. The goal was to create a “seamless, longitudinal record”—and that was the beginning of the largest health IT modernization project in history, Glueck said. And, although he didn’t mention it, the beginning of one of the VA’s biggest headaches. The problem, Glueck wrote, was that the new project involved “standardizing procedures and workflows that may have been different across 130 VistA implementations at largely autonomous VA medical centers.”

In June 2022—a significant month in the whole rollout process—Cerner was acquired by Oracle. By Glueck’s lights, that meant the VA “now has essentially 2 vendors for the price of one—one with extensive clinical expertise and one with extensive engineering expertise.”

Oracle, he said, “is hard at work to stabilize and improve performance; make fixes to functionality and design issues; improve training and build a better user experience.” He noted that significant improvements to the system’s capacity and performance have included reducing the most severe outage incidents by 67%.

In a recent statement, House VA Committee Chairman Mike Bost (R-IL) and Technology Modernization Subcommittee Chairman Matt Rosendale (R-MT) said, “We support Secretary McDonough’s decision in the strongest possible terms. The best way to get out of a hole is to stop digging, and we’re encouraged that VA and Oracle Cerner have finally realized that.”

VA and Oracle Cerner are currently working toward an amended contract that will "increase Oracle Cerner’s accountability to deliver a high-functioning, high-reliability, world-class EHR system,” the VA says. As part of the re-set, the VA also will work with Congress on resource requirements. The VA estimates FY 2023 costs will be reduced by $400 million. 

The painful paused and repaused rollout of the new Cerner electronic health record (EHR) system at the US Department of Veterans Affairs (VA) is now halted as the VA announces a “reset.” The decision applies to all planned deployments. An exception is the Captain James A. Lovell Federal Health Care Center in Chicago, the only fully integrated VA and US Department of Defense (DoD) health care system, which is expected go live in March 2024 as planned. The DoD rollout of its Cerner EHR is further along and expected to be completed in 2024.

The new plan is to redirect resources and “prioritize improvements” at the 5 sites currently using the new EHR: Spokane VA Health Care System, VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care, and VA Central Ohio Health Care System. Additional deployments will not be scheduled, the VA says, until it is confident that the new EHR is highly functioning at the current sites and ready to deliver at future sites, as demonstrated by “clear improvements” in the clinician and veteran experience, sustained high performance and high reliability.

“For the past few years, we’ve tried to fix this plane while flying it—and that hasn’t delivered the results that veterans or our staff deserve,” said Neil Evans, MD, acting program executive director at the Electronic Health Record Modernization Integration Office. “This reset changes that. We are going to take the time necessary to get this right for veterans and VA clinicians alike, and that means focusing our resources solely on improving the EHR at the sites where it is currently in use, and improving its fit for VA more broadly. In doing so, we will enhance the EHR for both current and future users, paving the way for successful future deployments.”  

The various EHR rollouts around the country have been bumpy from the beginning, operating by fits and starts as new problems surfaced and were addressed. To be fair, the whole implementation process only started in 2020 (and deployed at the first VA hospital during the COVID-19 pandemic), but in that time, the VA has had to, in its own words, “revise the timeline” again and again. The Boise VA Medical Center, for instance, was originally scheduled to go live June 25, 2022, then a month later—then 2023.

The VA Office of the Inspector General published 3 reports last year that found significant issues, including improperly routed clinical orders. VA Secretary Denis McDonough announced last July that the VA would delay EHR deployments until January 2023 to ensure that the system’s issues had been resolved. “During VA’s subsequent investigation at our current sites,” he said, “several additional technical and system issues were identified—including challenges with performance, such as latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders.”

In February, Ken Glueck, executive vice president of Oracle, wrote a blog post that was both apologia and explanation. Modernization, he said, “doesn’t come with a magic wand and there’s no easy button.”

After the DoD moved to Cerner for a new EHR system, the VA decided to follow suit. The goal was to create a “seamless, longitudinal record”—and that was the beginning of the largest health IT modernization project in history, Glueck said. And, although he didn’t mention it, the beginning of one of the VA’s biggest headaches. The problem, Glueck wrote, was that the new project involved “standardizing procedures and workflows that may have been different across 130 VistA implementations at largely autonomous VA medical centers.”

In June 2022—a significant month in the whole rollout process—Cerner was acquired by Oracle. By Glueck’s lights, that meant the VA “now has essentially 2 vendors for the price of one—one with extensive clinical expertise and one with extensive engineering expertise.”

Oracle, he said, “is hard at work to stabilize and improve performance; make fixes to functionality and design issues; improve training and build a better user experience.” He noted that significant improvements to the system’s capacity and performance have included reducing the most severe outage incidents by 67%.

In a recent statement, House VA Committee Chairman Mike Bost (R-IL) and Technology Modernization Subcommittee Chairman Matt Rosendale (R-MT) said, “We support Secretary McDonough’s decision in the strongest possible terms. The best way to get out of a hole is to stop digging, and we’re encouraged that VA and Oracle Cerner have finally realized that.”

VA and Oracle Cerner are currently working toward an amended contract that will "increase Oracle Cerner’s accountability to deliver a high-functioning, high-reliability, world-class EHR system,” the VA says. As part of the re-set, the VA also will work with Congress on resource requirements. The VA estimates FY 2023 costs will be reduced by $400 million. 

The painful paused and repaused rollout of the new Cerner electronic health record (EHR) system at the US Department of Veterans Affairs (VA) is now halted as the VA announces a “reset.” The decision applies to all planned deployments. An exception is the Captain James A. Lovell Federal Health Care Center in Chicago, the only fully integrated VA and US Department of Defense (DoD) health care system, which is expected go live in March 2024 as planned. The DoD rollout of its Cerner EHR is further along and expected to be completed in 2024.

The new plan is to redirect resources and “prioritize improvements” at the 5 sites currently using the new EHR: Spokane VA Health Care System, VA Walla Walla Health Care, Roseburg VA Health Care System, VA Southern Oregon Health Care, and VA Central Ohio Health Care System. Additional deployments will not be scheduled, the VA says, until it is confident that the new EHR is highly functioning at the current sites and ready to deliver at future sites, as demonstrated by “clear improvements” in the clinician and veteran experience, sustained high performance and high reliability.

“For the past few years, we’ve tried to fix this plane while flying it—and that hasn’t delivered the results that veterans or our staff deserve,” said Neil Evans, MD, acting program executive director at the Electronic Health Record Modernization Integration Office. “This reset changes that. We are going to take the time necessary to get this right for veterans and VA clinicians alike, and that means focusing our resources solely on improving the EHR at the sites where it is currently in use, and improving its fit for VA more broadly. In doing so, we will enhance the EHR for both current and future users, paving the way for successful future deployments.”  

The various EHR rollouts around the country have been bumpy from the beginning, operating by fits and starts as new problems surfaced and were addressed. To be fair, the whole implementation process only started in 2020 (and deployed at the first VA hospital during the COVID-19 pandemic), but in that time, the VA has had to, in its own words, “revise the timeline” again and again. The Boise VA Medical Center, for instance, was originally scheduled to go live June 25, 2022, then a month later—then 2023.

The VA Office of the Inspector General published 3 reports last year that found significant issues, including improperly routed clinical orders. VA Secretary Denis McDonough announced last July that the VA would delay EHR deployments until January 2023 to ensure that the system’s issues had been resolved. “During VA’s subsequent investigation at our current sites,” he said, “several additional technical and system issues were identified—including challenges with performance, such as latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders.”

In February, Ken Glueck, executive vice president of Oracle, wrote a blog post that was both apologia and explanation. Modernization, he said, “doesn’t come with a magic wand and there’s no easy button.”

After the DoD moved to Cerner for a new EHR system, the VA decided to follow suit. The goal was to create a “seamless, longitudinal record”—and that was the beginning of the largest health IT modernization project in history, Glueck said. And, although he didn’t mention it, the beginning of one of the VA’s biggest headaches. The problem, Glueck wrote, was that the new project involved “standardizing procedures and workflows that may have been different across 130 VistA implementations at largely autonomous VA medical centers.”

In June 2022—a significant month in the whole rollout process—Cerner was acquired by Oracle. By Glueck’s lights, that meant the VA “now has essentially 2 vendors for the price of one—one with extensive clinical expertise and one with extensive engineering expertise.”

Oracle, he said, “is hard at work to stabilize and improve performance; make fixes to functionality and design issues; improve training and build a better user experience.” He noted that significant improvements to the system’s capacity and performance have included reducing the most severe outage incidents by 67%.

In a recent statement, House VA Committee Chairman Mike Bost (R-IL) and Technology Modernization Subcommittee Chairman Matt Rosendale (R-MT) said, “We support Secretary McDonough’s decision in the strongest possible terms. The best way to get out of a hole is to stop digging, and we’re encouraged that VA and Oracle Cerner have finally realized that.”

VA and Oracle Cerner are currently working toward an amended contract that will "increase Oracle Cerner’s accountability to deliver a high-functioning, high-reliability, world-class EHR system,” the VA says. As part of the re-set, the VA also will work with Congress on resource requirements. The VA estimates FY 2023 costs will be reduced by $400 million.