House bill pressures VA to get EHR back on track, or risk contract termination
A House lawmaker sent a clear shot across the Department of Veterans Affairs’ bow with the introduction of a draft bill Wednesday that threatens the conditional termination of the VA’s landmark electronic health record modernization contract with Oracle Cerner if they can’t get the effort back on track.
The bill from Rep. Nikki Budzinski, D-Ill., would place what she called new “guardrails and expectations” on the department’s troubled EHR rollout. If those aren’t met within two years, Congress would restrict the VA from issuing any new work under the contract, which has ballooned to a total estimated cost of $37 billion, up from the initial 2018 price tag of $10 billion.
Speaking during a legislative meeting of the House Committee on Veterans’ Affairs, Budzinski said the “VA has only managed to deploy the system at six hospitals” after experiencing “delays, patient safety concerns and dramatic impacts on veterans’ access to care.” Because of those issues, the VA put further rollout of the program on pause in 2023 and reworked many of the service-level agreements in the contract with Oracle Cerner.
The heart of the new legislation, Budzinski signaled, would be requiring the VA to “create a baseline of clinical and business workflows, as well as technical requirements, to ensure the standardization of VA practices and systems.” On top of that, it would also set new “health care quality metrics” based on the VA’s own Strategic Analytics for Improvement and Learning Value Model, and new reporting and independent verification and validation requirements.
The VA would also be prevented from launching the EHR system at additional medical facilities unless the department can certify that the system buildout and configuration are accurate and complete, the staff and infrastructure are prepared for rollout, possible “adverse effects” have been mitigated, and the system meets 99.9% uptime before certification.
If the bill is signed into law, the secretary of the VA would have two years to return to Congress a certification that the legislation’s requisite baselines and metrics “show consistent improvement.” During the same period, Budzinski wants to see at least two additional VA medical facilities launch the EHR upon meeting the certification requirements laid out in the bill.
At that point, if the VA can’t get both of those things done, it would be restricted from issuing any new options or extending the contract with Oracle Cerner — though it would be allowed to continue any previous contractual work until it expires.
The legislation comes as the VA has plans to expand the EHR’s rollout to 13 new sites in 2026. Despite continued concern from overseers like Budzinski on Capitol Hill, the VA believes that after the relaunch, this time things will be different.
“Everyone can be certain this time that our leaders are focused, engaged, and owning it,” VA Deputy Secretary Paul Lawrence wrote in a blog post published Tuesday. Lawrence said he has visited 12 of the 13 facilities next up, and will visit the final one next month. “This time, everyone is dialed in, and it is influencing how we drive our deployments,” referring to the “more than 400 individuals” he engaged with on those trips.
Even the six facilities currently running the modernized Oracle Cerner platform have found their groove, according to Lawrence, pointing to “13,000 users who have provided health care to over 188,000 Veterans” at those sites.
“Oracle Health has improved system performance, reliability and usability, including operating at 100% outage-free for 27 of the last 31 months (June 2023 – December 2025), with 100% attainment of ticket management targets for 30 consecutive months (July 2023 – December 2025), and 100% attainment of Incident-Free Time for nearly two years straight (March 2024 – December 2025),” he wrote.
