Officials from the Department of Veterans Affairs (VA) told members of Congress this week that the agency’s Electronic Health Records Modernization (EHRM) program has seen improvements in terms of total outage time, but also that VA employees are still unsatisfied with the EHR system.
At a House Veterans’ Affairs Committee hearing on Nov. 15, Chairman Matt Rosendale, R-Mont., shared insights from a recent survey conducted by KLAS Research that found that only 26 percent of VA employees agreed that the EHR system was available when they needed it.
“It is true that complete nationwide outages have become less and less common over the past year. But crashes, hangs, and errors that affect one facility, one module, or one person are still widespread,” Chairman Rosendale said. “Ultimately, what the users experience is what counts and they are not happy.”
According to the VA and Department of Defense (DoD) – which also uses Oracle Cerner’s Millennium EHR platform – incident-free time under their control was between 95 percent and 99 percent this year. According to the contractor Oracle Cerner, incident-free time under the company’s control was between 87 percent and 97 percent during the year.
However, VA Chief Information Officer (CIO) Kurt DelBene told the committee that Oracle Cerner is still not meeting a standard in its contract that calls for 95 percent “incident free time” on a regular basis.
The CIO said that as of Sept. 30, 2023, Oracle has reached this metric only four of the past 10 months.
“This partially is from the number of changes that are being introduced,” DelBene said. “It’s a well-established axiom of software development that systems stabilize when the rate of change made in the system decreases. The rate of change is still very high, resulting in more instances than we would like.”
“Ultimately, we anticipate that the system’s performance will improve when change velocity decreases, and enough time has passed to enable unanticipated defects to be found and addressed,” he added.
The VA is in the middle of a “program reset” in order to address such challenges and improve system reliability before it deploys the EHRM program at other VA sites. Currently, the program is deployed at five sites across the country.
The only exception to the full-stop on EHRM deployment activities is at the Captain James A. Lovell Federal Health Care Center near Chicago – the only healthcare facility to serve both DoD and VA patients. The new EHR system is scheduled to go-live at this site in March 2024.
With the current efforts underway, DelBene said VA leaders are “optimistic” about the upcoming deployment and “the future full implementation of the Federal EHR throughout VA.”
“Having said that, we will not do this until the system is ready to provide a good quality experience to users,” he said. “Overall, we still think there’s a ways to go. I don’t want to present the system as all set and ready to go – there are places we have significant concerns that we’re working with Oracle on.”
Mike Sicilia, executive vice president of Oracle Global Industries, was not in attendance for the hearing as he had a prior commitment. Nevertheless, Ranking Member Sheila Cherfilus-McCormick, D-Fla., noted her disappointment that Oracle did not send another representative for the hearing.
“I’m disappointed that Oracle Health isn’t here to participate in this conversation,” she said. “The fact that they didn’t send a representative raises major concerns for me, and I expect better. I’m constantly losing faith in the process.”
