Categories
USA Veteran News

VA’s $16 billion health records overhaul may be scrapped if fixes aren’t made

[ad_1]

House lawmakers warned that they may kill off the Department of Veterans Affairs costly and complicated electronic health records modernization effort unless officials can show significant progress in coming months.

Administrators “have to fundamentally improve,” said Rep. Mike Bost, R-Illinois, ranking member of the House Veterans’ Affairs Committee, during a hearing on the topic Wednesday. “If we don’t see major progress by early next year, when VA says they intend to roll [the effort] out to larger sites, we will have to seriously consider pulling the plug.”

“I hope the situation can somehow be turned around. But everyone involved in this needs to understand that the consequences are real, and that there are no blank checks.”

The criticism from House members came amid the second tense hearing for VA health records officials in the past week.

On July 20, members of the Senate Veterans’ Affairs Committee grilled department leaders over new delays in the 10-year modernization effort and reports that the $16 billion price tag could more than triple in coming years.

Just a few days earlier, the VA Inspector General’s office released a new report detailing 149 cases of patient harm caused by the implementation of the new Oracle Cerner Millennium records software over a nine-month period at the department’s hospital in Spokane, Washington.

A flaw in the system sent about 11,000 orders to an unknown and unchecked file, where requests for items such as appointments or blood tests went unanswered. In at least two cases, the lost files caused “major harm” to patients.

The health records overhaul was announced by then-President Donald Trump in 2017 as a way to bring veterans health records onto the same system as the military, providing troops with a lifelong medical file.

But the effort has been beset by problems for the past few years. The new software has been deployed to sites in Ohio and Washington, but additional planned rollouts for 2022 have been delayed until 2023 amid the mounting concerns.

In testimony Wednesday, Dr. Terry Adirim, director of the Electronic Health Record Modernization Integration Office, pushed back on the cost overrun estimates, saying they are based on the assumption putting the system in place will take more than 10 years.

“We are still in the process of planning for a 10-year deployment and we should have a schedule out sometime in the fall,” she said. “However, there have been delays, and so it’s reasonable to expect that it could go beyond that, and we are doing that kind of contingency planning.”

Lawmakers called the situation troubling.

Bost said he intends to draft legislation protecting patients and taxpayers from the program spiraling out of control.

If Republicans win control of the House in the November election, he likely will take over as chairman of the committee and would wield considerable legislative power on the issue.

Current committee Chairman Mark Takano, D-California, said he still believes that the department must upgrade its records system but “I will not sit idly by and allow this program to endanger veterans.”

Rep. Matt Rosendale, R-Montana, called the system “fully dysfunctional” and said he believes it is “not safe or suitable to roll out anywhere else.”

Other panel members said they will work with VA officials to “hold program officials accountable,” which could mean reprimands and dismissals in coming months.

VA officials have promised overhauls to the training programs to better prepare staff for future deployments. Leaders at Oracle Cerner have said publicly they are committed to fixing past problems with the system.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

[ad_2]

Source link

Categories
USA Veteran News

VA’s $16 billion medical records overhaul could triple in cost

[ad_1]

Veterans Affairs officials announced Wednesday they will delay the planned deployment of the department’s new electronic medical records to sites in Idaho amid concerns the $16-billion project could be endangering veterans and may triple in cost.

Senate lawmakers said the latest postponement — and other promised fixes to the training and deployment process — don’t go far enough to acknowledge the deep-seated problems with the system, some of which may not be reparable.

“For nearly two years, [local employees] have done all they can to provide healthcare to veterans in the middle of a pandemic, and with an electronic health record system that is not delivering,” Senate Veterans’ Affairs Committee Chairman Jon Tester, D-Mont., said during a hearing on the issue.

“We know this program faces very real problems. And we need to work together to make needed improvements without delay.”

But VA officials said they are not abandoning the project, despite growing concerns about its long-term viability.

“We’ve learned from these issues around patient safety,” VA Secretary Denis McDonough said at a separate press event Wednesday. “Our veterans deserve to have access to 21st century healthcare in a way that protects them and enhances their interests.”

The 10-year, $16 billion project was approved in 2017 by President Donald Trump and touted by his administration as a transformational event for the department by putting VA records on the same system as the Department of Defense for the first time. Military officials began using a new records system based on the same software in 2015.

But last week, the VA Inspector General’s office released a new report detailing 149 cases of patient harm, all of which were caused by the implementation of the new Oracle Cerner Millennium records software over a nine-month period at the department’s hospital in Spokane, Wash.

A flaw in the system sent about 11,000 orders to an unknown and unchecked file, where requests for items such as appointments or blood tests went unanswered. In at least two cases, the lost files caused “major harm” to patients.

The report was the latest in a series of negative assessments of the system unveiled by the inspector general over the last two years, several of which have prompted reviews and delays.

One month ago, the department announced plans to delay deployment to sites in Washington and Oregon because “the system hadn’t shown adequate reliability to support the current schedule.”

The latest delay came this week, when VA leaders announced plans to postpone deployment of the records system to sites in Boise, Idaho. That work was scheduled to begin this weekend.

Meanwhile, lawmakers are also scrutinizing the cost of the project after officials said the total over the next 30 years could approach $51 billion, when factors such as system maintenance, care changes and staffing issues are factored in.

“It is $40 billion over the cost estimate VA has been operating under until now,” said Sen. Jerry Moran, R-Kansas, ranking member of the veterans committee. “But until Monday, we were not aware how large that cost overrun truly is.”

VA officials said that those calculations factor in a host of expected costs outside of the software contract, and are not indicative of an over-budgeted endeavor. They also said they do not expect the system to cost more than the $16 billion agreed-upon price tag unless the 10-year implementation timeline is extended significantly.

But they did acknowledge shortcomings in training and adaptation of the software in past years.

Administrators promised that recent corrections — such as establishing new oversight protocols and staff training plans — would keep the project on schedule and produce the robust records system promised to staff and patients.

“We’ve taken sufficient steps to build additional safeguards, knowing where the vulnerabilities are based on experiences we’ve had, to reduce the risk of additional harm or to reduce the likelihood of similar problems occurring and other sites,” Dr. Gerard Cox, VA’s assistant under secretary for health for quality and patient safety.

“I feel like we have done everything possible to reduce the risk to patients.”

Officials from Oracle Cerner have said that many of the initial problems with getting the new system integrated into VA were expected and reparable.

“While I fully appreciate substantial challenges exist – all of which are legitimate and understandable – the fact is that more is working than is not,” said Mike Sicilia, executive vice president of Oracle Corporation, which took over the contract earlier this summer when it bought Cerner.

“There is nothing here that can’t be addressed in reasonably short order.”

Part of that work will be shifting operations to a new cloud-based system, in order to prevent outages and stalls. Officials said they have had nearly 50 such problem events since the first VA site began using the Millennium software.

Lawmakers remain skeptical.

In a statement last week, House Veterans’ Affairs Committee Chairman Mark Takano, D-Calif., said he was “extremely disappointed” with the process so far, including VA’s transparency about ongoing problems.

Committee ranking member Mike Bost, R-Ill., said he has “serious doubts about whether this project should continue, even if the fatal flaws at the initial rollout sites are fixed” because of the ongoing cost and safety questions.

Several other lawmakers have pushed for VA to abandon the project, a move that would cost billions of dollars and leave the department’s medical records systems with an uncertain future. McDonough said he is not considering that option.

“We will get to the bottom of these problems, and make sure that we can realize a modernized electronic health record that draws the full history of our veterans’ service to the country,” he said. “When we realize that potential, we will be able to expand exponentially the benefits for veterans and for the country.”

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

[ad_2]

Source link