“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,” Kurt DelBene, the VA’s chief information officer, said during a House Committee on Veterans’ Affairs hearing on the implementation of the VA’s EHRM initiative with Oracle Cerner. 

Oracle Cerner did not send a representative to the hearing despite being invited to.

“There are places we have significant concerns that we’re working with Oracle on: the incident-free time, not hitting standards is important, the end user responsiveness we think still has a ways to go, we think there are still functional workflow issues that still have to be resolved,” DelBene added.

The VA partnered with Oracle Cerner in 2018 to lead the development and implementation of its EHR modernization under a 10-year, $16 billion contract. But since then, the program has faced a number of significant challenges, some of which have reportedly brought harm to veterans. 

This led to bipartisan congressional criticism of the program and, ultimately, the decision in April by the VA to stop the rollout of the system at veteran hospitals until major patient safety issues are remediated.

Multiple members of Congress expressed frustration during the hearing that the VA and Oracle Cerner were not moving fast enough with improvements to the EHR system while spending billions in taxpayer dollars. 

“[Oracle] training and change management are still woefully inadequate and user satisfaction is still critically low,” said Rep. Sheila Cherfilus-McCormick, D-Fla., the ranking member of the House Veterans’ Affairs Subcommittee on Technology Modernization. 

“I’m disappointed that Oracle Health isn’t here to participate in this conversation. I would like to stress that they are not present with us today. 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,” said Cherfilus-McCormick.

VA Secretary Denis McDonough will next year make the final decision regarding the exact timing of the continuation of the EHR rollout.

Meanwhile, the VA continues to use the Veterans Health Information Systems and Technology Architecture (VistA) EHR system in almost all of its VA hospitals. The modernized EHR system meant to replace VistA was delivered to five VA facilities before the department halted its nationwide rollout. The legacy VistA system has faced its own issues, including a lack of interoperability and nationwide access for veterans who change hospitals or move between states. 

The post VA still has ‘significant concerns’ as Oracle works to get EHR modernization back on track appeared first on FedScoop.

“In the summer of 2024, we should be having, and even before that we should be having real discussions about whether we’re ready to move forward with [the EHRM] restart,” Dr. Neil Evans, acting program executive director of the VA’s EHRM Office, said during a House Appropriations Oversight hearing on implementation of the VA’s EHRM initiative with Oracle Cerner.

The VA partnered with Oracle Cerner in 2018 to lead the development and implementation of its EHR modernization under a 10-year, $16 billion contract. But since then, the program has faced a number of significant challenges, some of which have reportedly brought harm to veterans. This led to bipartisan congressional criticism of the program and, ultimately, the decision in April by the VA to stop the rollout of the system at veteran hospitals until major patient safety issues are remediated.

The VA also renegotiated its contract with Oracler Cerner in a way that it believes “dramatically increases” its ability to hold the technology company to account for the system’s performance.

Speaking at Wednesday’s hearing, Mike Sicilia, executive vice president at Oracle, said: “I would concur with Dr. Evans’s time frame. It seems to me next summer we should be in a position, particularly if the go-live is trending well in March, that we should be in a position to resume [the rollout]. That is our expectation.” 

VA Secretary Denis McDonough will next year make the final decision regarding the EHR rollout timeframe, according to Evans and Sicilia.

The VA currently uses the Veterans Health Information Systems and Technology Architecture (VistA) EHR system in almost all of its VA hospitals. The modernized EHR system was delivered to five VA facilities before the department halted its nationwide rollout. VistA has faced its own issues including a lack of interoperability and nationwide access for veterans who change hospitals or move between states. 

Evans also said there are major issues in having two different EHR systems operating within the VA rather than one central, functioning EHR system.

“I wake up every day wondering are we moving in this direction? We don’t want to stay in reset forever. In fact, I would argue that we’re at higher risk the longer we maintain a healthcare system that’s running two different electronic healthcare systems. So we need to feel an urgency to move forward with a single electronic health record system,” he said.

Multiple members of Congress expressed strong frustration during the hearing that the VA and Oracle Cerner were not moving fast enough with improvements to the EHR system while spending billions in taxpayer dollars. 

“$10 billion dollars of taxpayer dollars. What the hell has that gotten us? What if we cut funding? What if next year it was zero? Would that light a fire in terms of fixing this program?” said Rep. Tony Gonzales, R-Texas.

The post VA, Oracle Cerner expect problem-ridden EHR rollout to resume by summer 2024 appeared first on FedScoop.

The department’s IG received an allegation that Oracle Cerner had submitted invoices for approximately $5.8 million between October 2019 and March 2020 with progress reports on deliverables that were not adequately detailed.

While the IG wasn’t able to substantiate those claims, it did report that the VA’s timeline for working with Oracle Cerner to correct issues with insufficient progress reports connected to invoices wasn’t adequate and could be improved.

“The complainant reported being told the progress report was just ‘a cover page, there’s an agenda, there’s six empty pages, there’s an ending. That’s what they turned in to get paid for this deliverable,’” the VA OIG management advisory memorandum issued Wednesday said.

The IG found there was actually detailed information in the progress reports, so it didn’t substantiate the allegation. However, the watchdog did conclude that “VA lacked timelines for when contractors needed to provide corrections to insufficient progress reports,” and therefore “the delays observed for contractors’ corrections to progress reports could limit VA’s ability to promptly and accurately monitor contractors’ progress on particular tasks.”

For 18 of the 48 Cerner progress reports reviewed by the IG, the VA required Oracle Cerner to resubmit the report with corrections, to which Cerner complied. But because there was no timeline in place, it impacted the VA’s ability to properly manage actions from the multiple and ongoing reports.

The IG requested that the VA inform it regarding what actions, if any, it plans to take to strengthen the deliverable review process in future contract requirements.

The VA’s EHR modernization office concurred with the information in the memorandum and had no additional comments. In addition, the VA’s Office of Information and Technology agreed with the memorandum without comment.

Veterans Affairs CIO Kurt DelBene told FedScoop last month that he is “cautiously optimistic” that Oracle Cerner can turn around EHR modernization after years of grave performance issues since it was rolled out in October 2020, including repeated outages that, according to the agency’s watchdog, have resulted in serious harm to veterans.

In May, the department announced it had reached a revised contract agreement with Oracle Cerner that it said “dramatically increases” the government’s ability to hold the contractor accountable for reliability, responsiveness and interoperability.

The post VA stands to improve payment process for controversial EHR contract, watchdog reports appeared first on FedScoop.

Cerner Enviza, an Oracle company, along with John Snow Labs, will help support the FDA’s drug safety Sentinel Initiative by using AI technology that will be used for two years to explore the possible mental health side effects arising from use of the asthma drug montelukast.

As part of the contract, the technology company will explore how machine learning and natural language processing can fill gaps in medical data collection. 

“This is an incredible opportunity to work with these exceptional leaders to use Oracle’s de-identified EHR data to help transform unstructured clinical notes into validated and useable data for physicians and researchers,” Mike Kelly, global head of Cerner Enviza said in a press release. “Connected technologies and unified data can accelerate innovation and, in turn, help providers realize better recommendations and outcomes for their patients.” 

The current manual methods for analyzing clinician notes can often prevent a full understanding of the symptoms and outcomes that patients experience at the population level but advances in artificial intelligence offer scalable and transportable natural language processing (NLP) systems, Cerner Enviza said.  

Cerner Enviza and John Snow Labs will together develop a new methodology to enhance computerized queries, or phenotyping, of digital patient data and clinical notes to support pharmacoepidemiology.

Cerner Enviza, was chosen to lead the contract by the Sentinel Innovation Center, who is headed by Mass General Brigham and Harvard Pilgrim Health Care Institute.

“Development and evaluation of tools that can enhance our ability to utilize unstructured EHR data is a key strategic priority for the Sentinel Innovation Center. We look forward to this new relationship and exciting initiative led by Cerner Enviza,” said Rishi Desai, Ph.D., Mass General Brigham executive leadership team member, Sentinel Innovation Center. 

The Sentinel Initiative is the FDA’s national electronic system for monitoring the safety of FDA-regulated medical products including drugs, vaccines, biologics and medical devices. It was launched in May 2008 in response to the passage of the FDA Amendments Act.

The post Oracle Cerner signs AI contract with FDA focused on improving medicines appeared first on FedScoop.

Responding to reporters’ questions Monday at an event hosted by the Defense Writers Group, McDonough clarified that the department is looking very closely at the go-live, and that it is working through an implementation check list for each hospital set to receive the new system.

“I think we’ve been clear that we have to be confident that these risks to patient safety are addressed before we go live. So we’re not just focused on the passage of time between now and next year, we’re focused on improving the system,” McDonough said.

The VA earlier this year in June its plans to delay moving forward with the rollout of its problem plagued Oracle Cerner-operated electronic health record platform to early 2023 from 2022.

At that time, a VA spokesperson said the EHR system would be delayed at American Lake and Seattle VA medical centers to March 2023, which make up the VA’s Puget Sound Health Care System. This pushed back implementation by seven months from the previously scheduled August 2022 deployment.

The decision to defer implementation at the four sites follows the publication of details about a draft watchdog report that found at least 148 veterans were harmed during the department’s rollout of the system at a health center in Spokane, Washington.

“We won’t go to roll out the EHR in any of the other hospitals until we have a go-live checklist addressed and until we have our patient safety concerns [addressed], and then we’ll be in a position to make a decision on rollout,” McDonough said.

The EHR system rollout issues has been plagued by outages — including at the VA’s medical center in Spokane, Washington — that have caused major harm to veterans. The implementation of VA’s new EHR system is expected to be delayed from its original estimates by at least one to two years.

The post VA Secretary says Oracle-Cerner EHR rollout will not continue until patient safety risks are addressed appeared first on FedScoop.

At a House hearing Tuesday, Rep. Rosendale, R-Mont., cited a figure of $156,750 that according to the lawmaker the VA has withheld from the technology giant, and contrasted this with number of outages that have occurred since the rollout of the EHR system.

“Why has the VA only withheld $156,750 for Cerner’s failure to meet the service level agreement for the system up time? Do you think it’s a fair penalty for over 44 days of outages, degradations and losses of functionality?” said Rosendale.

The lawmaker was referring to the almost 500 major incidents with the VA’s Oracle-Cerner electronic health records system and at least 45 days of downtime that have occurred within the system since it was rolled out in the fall of 2020. Details of the downtime were included in an internal VA dataset exclusively obtained by FedScoop through a Freedom of Information Act.

Giving evidence at the hearing, Michael Parrish, the VA’s chief acquisition officer, replied to Rosendale saying that Oracle-Cerner’s failures would not be tolerated in the private sector. Parrish also said that the agency requires further financial support from Congress to modernize all of its aging technology systems.

“69% of VA medical centers are more than 50 years old and require full modernization. VA’s infrastructure footprint is not flexible enough, and changes in Veteran’s needs, demographics and locations are outpacing our ability to transform and manage it,” said Parrish.

He added: “With additional funding, VA would be better poised to modernize the full portfolio of assets to best serve our Veterans.”

The rollout of the electronic health records modernization continues to attract scrutiny from lawmakers following recent new research from the Institute for Defense Analyses, a nonprofit, that puts the life cycle cost of the EHR system at $50.8 billion over 28 years. The VA’s original rollout implementation tag was about $10 billion over 10 years.

The EHR system rollout issues has been plagued by outages — including at the VA’s medical center in Spokane, Washington — that have caused major harm to veterans. The implementation of VA’s new EHR system is expected to be delayed from its original estimates by at least one to two years.

Rosendale, who is the House VA Subcommittee on Technology Modernization Ranking Member, asked the VA for the total amount that the agency has withheld from Oracle-Cerner for failures on their end and is expected to get an answer in writing from the agency.

Speaking also at the hearing, House VA Committee Chairman Rep. Mark Takano, D-CA., highlighted that the recently passed veterans healthcare expansion bill – the PACT Act – would benefit veterans and the VA by allowing it to hire more employees and invest in modernising its technology given a record new 3.5 million veterans who’ve become eligible for the VA recently.

“Everything at the VA has an IT component and when there’s an IT component that almost always requires an acquisition of technology and support. We’ve seen what happens when the VA does not plan and execute these major acquisitions,” Takano said.

The post Rep. Rosendale questions size of penalty imposed on Cerner-Oracle by VA amid electronic health record system failures appeared first on FedScoop.

It is the latest problem to hit the VA’s troubled electronic health records modernization program, which has provoked ire from lawmakers and VA frontline medical staff.

The system went down for approximately three hours, resulting in downtime and delays to VA patients databases in the middle of the day, while the corrupted database was fixed and reprogramed.

“It meant that something is programmed incorrectly. It could mean bad data. In this case, it means they needed to rebuild the indexes (how the different files know where the patient data is in a different file),” said a source with visibility into the shutdown, speaking with FedScoop on the condition of anonymity.

“If this issue wasn’t found and corrected, one patients files could point to a different patients data. There is no way this should happen,” the source added. 

VA and Cerner define a system outage as an “unscheduled system event where the entire EHR solution becomes unavailable to users and/or downtime procedures are implemented.”

The VA’s Office of Inspector General earlier this year published a trio of reports that identified major concerns about care coordination, ticketing and medication management associated with the EHR program launch.

The implementation of the VA’s new EHR system on an Oracle-Cerner developed platform to medical centers around the country has been delayed from its original estimates by at least one to two years due to long-identified issues with the program’s reliability and safety that could put veterans in danger.

The system rollout is far behind where it was expected to be at the moment, a top VA executive said during a Senate hearing in July. 

The EHR system rollout issues have in some instances, including at the center in Spokane, Washington, caused major harm in which a veteran at risk for suicide did not receive treatment because records disappeared in the computer system.

VA spokesperson Terrence Hayes said: ““VA experienced a system outage of its electronic health Record system on August 4, 2022, which also affected VA, Department of Defense and U.S. Coast Guard sites using the Oracle-Cerner EHR. At 12:07 p.m. EDT, Oracle-Cerner received monitoring alerts indicating an issue with one of its databases. The system was taken offline to execute recovery of the database, during which time the sites switched to standard downtime procedures.

He added: “During downtime of the EHR, medical personnel could still care for patients, but documentation occurred on paper. The system was fully restored for all end-users at 4:23 p.m. EDT, for a total downtime of 4 hours and 16 minutes. No data corruption or data loss occurred.”

Editor’s note: This story was updated to include comment and additional information from the VA.

The post VA Cerner EHR system goes down for over 4 hours due to patient database corruption issue  appeared first on FedScoop.

The EHR modernization rollout effort at the Boise VA Medical Center has been postponed indefinitely due to long-identified issues with the program’s reliability and safety that could put veterans in danger.

“I want to make it clear that this weekend’s decision is not a setback, but rather part of the process,” Steven Lieberman, Deputy Under Secretary for Health at the VA said in an email to staff on Wednesday obtained by FedScoop.

“Patient safety and burden on our medical personnel are foremost on our minds, and any adjustments to the go-live schedule reflect this focus,” Lieberman added.

The EHR system rollout issues at other VA medical centers like at the center in Spokane, Washington, caused major harm in which a veteran at risk for suicide did not receive treatment because records disappeared in the computer system.

The implementation of the VA’s new EHR system on an Oracle-Cerner developed platform to medical centers around the country will be delayed from its original estimates by at least one to two years and the system rollout is far behind where it was expected to be at the moment.

Lieberman said the VA will continue to work with Oracle Cerner to improve the software of the EHR system and make it more stable. 

Kurt DelBene, the chief information officer at the VA, said during a Senate hearing Wednesday that the Oracle-Cerner EHR system had major stability issues primarily related to change control and testing; challenges with increased capacity; basic functionality; its resilience design, and its response in last resort disaster situations. 

When asked for comment on the positive outlook provided in Leiberman’s email despite multiple setbacks within the EHR rollout, the VA defended its decision for the Boise center.

“While there are many positive improvements since VA first went live with the new EHR in October 2020, in assessing Boise’s readiness for deployment this weekend, VA made the decision that, at this point, additional improvements still need to be made to ensure a safe and successful deployment,” said Terrence Hayes, Press Secretary Department of Veterans Affairs.

The VA’s next scheduled EHR software deployment will occur in January of 2023, in Saginaw and Ann Arbor, Michigan, Lieberman said.

“During this short interim, we will not be idle; there is much work to do as we prepare for future successful EHRM deployments in 2023,” he added.

The post VA health leader says delays in Cerner EHR rollout are ‘part of the process’ in internal memo appeared first on FedScoop.

Following the enactment of the bill, the Department of Veterans Affairs must report costs of its electronic health records modernization program to congressional committees on a quarterly basis and must start doing so within 90 days.

To comply with the legislation, VA will also be required to provide a breakdown of program funding sources in its reports. The bill was introduced by Sens. Jerry Moran, R-Kan., and Jon Tester, D-Mont.

The legislation was passed amid frustration among lawmakers over the access to information about the modernization program being granted by the VA. It achieved wide bipartisan support from a long list of lawmakers.

In March, the department’s Office of Inspector General published a trio of reports that identified major concerns about care coordination, ticketing and medication management associated with the EHR program launch.

Earlier this week, the VA confirmed that it would delay the rollout of its electronic health record system at four VA medical centers from 2022 to 2023.

Commenting on the new law, Sen. Moran said: “The VA, and consequently our nation, has invested a great deal of time and money into the VA Electronic Health Record Modernization program.”

“The potential benefits of this program are important, and it is vital to get it right. Now that this legislation has been signed into law, we can make certain the VA is providing the proper transparency throughout the EHRM implementation,” he added. “This will better allow the committee to conduct oversight during the deployment process to ensure veterans receive the care they deserve and hold the VA accountable for taxpayer dollars.”

Sen. Tester said that it’s “clear that VA’s Electronic Health Record Modernization program is not working for veterans, VA employees, or taxpayers.” He added: “I’m proud to have worked with Senator Moran and our colleagues to get our bipartisan bill across the finish line, allowing us to increase oversight and transparency on behalf of the VA medical staff using this program, so we can better provide our nation’s veterans the quality care they have earned.”

The post Biden signs VA health record modernization transparency act into law appeared first on FedScoop.

In a statement Tuesday, a VA spokesperson said the system will now be delayed at American Lake and Seattle VA medical centers in March 2023, which make up the VA’s Puget Sound Health Care System. This pushes back implementation by seven months from the previously scheduled August 2022 deployment.

VA will also delay deployment of the platform across the VA’s Portland Health Care System, which consists of VA medical centers in Portland and Portland-Vancouver. The rollout of the EHR platform in both cases has been shifted from November 2022 to April 2023.

The decision to defer implementation a the four sites follows the publication of details about a draft watchdog report that found at least 148 veterans were harmed during the department’s rollout of the system at a health center in Spokane, Washington. Details of the delayed implementation were first reported by Military Times.

In addition, the department has taken the decision to push back the rollout of the system at Idaho’s Boise VA Medical Center until July 23.

The EHR rollout in Boise was previously scheduled for June 25, and according to a Hill source, lawmakers were last Friday informed of the decision to delay this deployment date.

In an emailed statement, a VA spokesperson said the decision to delay further implementation of the platform at these locations was sparked by continued outages and concerns over system resiliency.

“The date was changed to allow Oracle Cerner to put important system enhancements in place and make the necessary improvements to ensure system stability (securing the 99.9% uptime Service Level Agreement currently contracted) as well as fix outstanding issues to address research workflow challenges,” said the emailed statement.

VA has requested also that Oracle Cerner develop an execution plan to put regular system testing and confirmation of resiliency in place.

The department added: “The revised deployment schedule will enable Oracle Cerner to address these potential gaps in system reliability, particularly in the more complex sites that are upcoming, such as Puget Sound and Portland. VA is highly confident that this deployment schedule can be achieved and is doing everything possible to ensure safe and successful deployments.”

The post VA delays electronic health record system rollout from 2022 to 2023 at four sites appeared first on FedScoop.