The bill, introduced by the chair of the House VA Committee along with nine other Republicans, would prohibit VA Secretary Denis McDonough from bringing the new electronic health record system to more hospitals before the VA and the company behind the system, Oracle Cerner, resolve the technical issues that have caused safety risks and reduced the capacity of hospitals and clinics where it has been deployed.
One of the bill's sponsors, Rep. Cathy McMorris Rodgers of Spokane, said in a statement the project's goal was clear when the VA signed a $10 billion contract in 2018 to replace its aging but reliable computer system with Oracle Cerner's: "Make sure veterans receive the best care possible at VA facilities."
"Five years later, it's abundantly clear that it's come up short," she said. "Veterans and providers in Eastern Washington have endured enough physical and emotional harm. Real change is long overdue and necessary to make this system the improvement we hoped it would be. I'm proud to help lead this legislation to force Oracle Cerner and VA leadership to finally take the meaningful action they've been avoiding."
The VA Electronic Health Record Modernization Improvement Act would require each VA medical center's director, chief of staff and regional administrator to certify that the system has been correctly configured, that staff are prepared to use it and that launching the system "will not have significant, sustained adverse effects on patient safety, patient wait-times for medical care, or health care quality."
Before the system could be deployed at other facilities, the VA secretary would also need to certify in writing to the House and Senate VA Committees that Oracle Cerner has made all contractually mandated fixes and that the system has been fully operational 99.9% of the time for four straight months. In May 2022, the VA official in charge of the project told The Spokesman-Review that Cerner — which was acquired by the tech giant Oracle a month later — had failed to meet that "uptime" requirement in the contract.
The system's rollout has been delayed several times since its launch in October 2020 at Spokane's Mann-Grandstaff VA Medical Center and its affiliated outpatient clinics in Coeur d'Alene, Wenatchee, Sandpoint and Libby, Montana. Despite reports of patient safety risks caused by the system's use, the VA launched it at a second hospital in Walla Walla in March 2022, followed by facilities in Ohio and Oregon in April and June.
The bill's lead sponsor is Rep. Mike Bost, an Illinois Republican who chairs the committee. Other sponsors include Rep. Matt Rosendale of Montana, who leads a subcommittee focused on VA technology modernization, and Reps. Dan Newhouse of Sunnyside, Cliff Bentz of Eastern Oregon and Mike Carey and Troy Balderson of Ohio, all of whom have VA facilities using the new system in their districts.
"I have traveled across the country and seen and heard firsthand the impact the Oracle Cerner product has had on VA providers and veterans," Bost said in a statement. "It has crippled the delivery of care, put veteran patient safety at risk, and stressed an already overwhelmed healthcare system."
While he commended McDonough for deciding in October to postpone the system's launch at other facilities until at least mid-2023, Bost added, "I am not confident that will be enough," and said the system should not be implemented at any other sites until each hospital's leaders say their facilities are ready.
Rep. Mike Simpson of Idaho Falls also cosponsored the legislation. While the system has so far been deployed in Idaho only at clinics outside his district — in Coeur d'Alene, Sandpoint and Lewiston — it came within days of launching at the Boise VA Medical Center before a last-minute postponement in July 2022.
The bill was formally introduced on Friday without Democratic cosponsors and did not immediately have a counterpart in the Democrat-controlled Senate, suggesting it may not have a clear path to passage.
On the same day, Rosendale and Bost introduced a separate bill, first reported by FCW, that would completely scrap the project. As of Tuesday morning, no other lawmaker had joined that more aggressive legislation.
In an interview Monday — before the House Republicans announced their bills — Senate VA Committee Chairman Jon Tester, D- Mont., said he planned to hold multiple hearings on the Oracle Cerner system before its next launches, set for June and July in Saginaw and Ann Arbor, Michigan.
"I am anything but a technical genius," Tester said. "But what I can say is that you've got to fix the failures — and the failures are fairly well known — and you've got to do it in a timely manner and you've got to have the manpower to do that."
In a press briefing on Tuesday, McDonough disputed a Spokesman-Review report in December that Mann-Grandstaff leaders had reduced staff over the course of 2022 at the direction of regional VA leaders, but he declined to answer follow-up questions when asked if any part of the reporting was inaccurate. A VA spokesman did not immediately respond to a request for more detail on the secretary's claim.
"If they've been cutting staff," Tester said in reference to The Spokesman-Review's reporting, "it's news to me. And quite honestly, I don't see how you can justify that."
Tester worked with Sen. Patty Murray of Washington, his fellow Democrat on both the VA and Appropriations panels, to include language in the spending bill Congress passed in December that requires McDonough to send Congress a report on the status of the Oracle Cerner rollout.
The provision also withholds 25% of the roughly $1.76 billion Congress appropriated for the project in fiscal year 2023 until the VA chief certifies that the system is "stable, ready, and optimized" and that problems have been fixed such that the system "will enhance provider productivity and minimize the potential for patient harm."
While the House Republicans' bill unveiled Tuesday would have similar effect to those stipulations, it would block the system's rollout altogether rather than simply withhold funding for it.
If the system's rollout stays on schedule, the July deployment in Ann Arbor will mark its first launch at a "high-complexity" hospital, where problems with an electronic health record system could be amplified. Spokane's VA medical center is categorized as a low-complexity facility in terms of the services it provides.
© 2023 The Spokesman-Review (Spokane, Wash.), Distributed by Tribune Content Agency, LLC.
