- Bipartisan legislation introduced by two members of the Senate Committee on Veterans Affairs would establish a third party oversight group to monitor the VA's beleaguered $16 billion EHR rollout. The 11-member EHR Advisory Committee would include medical professionals, IT and interoperability specialists and veterans receiving care from the VA, and would operate as an independent entity.
- Sens. Jon Tester, D-Mont., and Marsha Blackburn, R-Tenn, introduced the bill Wednesday after a month of critical watchdog reports and revealing congressional hearings. The VA is expected to have an electronic records system in place at three VA sites by 2020, though the full implementation is on a 10-year timeline.
- The VA's EHR overhaul has been riddled with troubles from the jump, when Cerner was awarded a no-bid, 10-year, $10 billion contract in 2017. The new committee is the latest attempt to stabilize the project.
The efforts signal mistrust by lawmakers and other watchdogs over the agency, which has been dogged by controversy for several years over its EHR contracting.
VA Secretary Robert Wilkie assured lawmakers in September that the agency is "committed to a timeline that makes sense" and "working with DOD to understand the challenges and obstacles" they faced during their implementation. It took a year for Cerner to sign the no-bid $10 billion contract.
The first oversight committee was established by the House VA Committee in June and was followed by a call for the GAO to monitor the project carefully. Wilkie was in the middle of his Senate confirmation process in July when the VA announced the Office of Electronic Health Record Modernization to oversee the project.
HHS' Genevieve Morris was originally tapped to lead the office, but resigned the following month. The department attributed the departure to differences in opinion over where the project should be heading.
John Windom stepped into the role as interim director and was immediately tasked with filling hundreds of unfilled positions while configuring a shared oversight office with DOD. Meanwhile, Cerner had subcontracted 24 other businesses to assist with the implementation.
Windom told members of the House VA committee in November that he considered the project a "moving target": There were too many stakeholders, the cost of the 10-year project rose by billions, and progress was stifled by unfilled positions and leadership challenges.
Lawmakers and VA officials agreed last year that the project wasn't likely to get easier. That much was certain by March, when a handful of GAO reports shunned the VA for failing to implement EHR recommendations, among many other things. In addition to EHR troubles, OIG reports found the VA had "significant challenges" complying with information security laws and ProPublica published an unfinished United States Digital Service report alleging the agency's software is currently "flawed" and could "significantly disrupt" patient care.
The agency was also requesting $4.6 billion for its 2020 budget.
"USDS raises credible concerns that Community Care should have a veteran-centric approach, but despite these critiques, VA appears to be ignoring the problem or at least is unwilling to revisit its approach," House VA Committee Chairman Mark Takano, D-Calif., said in a statement. "Nowhere is this clearer than VA’s intention to formally request a funding transfer to implement the very IT solutions USDS raises concerns about."
If Tester and Blackburn's bill is passed, the forthcoming EHR Advisory Committee will be tasked with addressing those concerns by analyzing progress, managing risk, making sure medical staff and VA employees have a say in the EHR rollout, and bringing their findings to Wilkie — who, according to the bill, must meet with them at least twice a year.
Correction: A previous version of this article included corruption allegations the GAO has since deemed unsubstantiated. It also incorrectly characterized the timeline for finalizing the Cerner contract, which took a year to be signed, and misstated the rollout for the new EHR. The new system is expected to be in place at three sites by 2020, but full implementation is on a 10-year timeline.