Better communication still needed on VA’s EHR push, congressional watchdog says

The VA still needs to improve its internal communications about the massive EHR program it is undertaking to better include stakeholder viewpoints, a GAO found.
veterans affairs, veterans health, va
The George E. Wahlen VA Medical Center in Salt Lake City. (Veterans Health Administration / Flickr)

The Department of Veterans Affairs needs more input from clinicians and other stakeholders on its massive electronic health records (EHR) modernization effort, a recent Government Accountability Office investigation found.

The report says that the department took positive steps to create lines of communication — including “EHR Councils” comprised of doctors and other VA staff to give feedback — but those channels didn’t get enough information about the program.

More communication would result in better feedback, the GAO said, citing interviews with clinicians. The report recommends the VA “ensure the involvement of all relevant medical facility stakeholders,” which the department concurred with.

The EHR program is a complete overhaul of the “antiquated” health record and scheduling system currently used across the VA, known as Veterans Health Information Systems and Technology Architecture. The $16 billion, 10-year program seeks to migrate health records to a cloud system built by Cerner Millennium, while transforming the technology clinicians, hospital workers and VHA employees use to interact with patients.


Previous reports from government watchdogs have chided the VA for a lack of coordination and communication across stakeholder groups on the new system. Congressional hearings have also touched on the challenge of ensuring that medical professionals are included in the process of design and training the new IT systems. IT infrastructure issues also loom over the successful implementation of the program.

“GAO found that VA’s decision-making procedures were generally effective as demonstrated by adherence to applicable federal internal control standards for establishing structure, responsibility, and authority, and communicating internally and externally, but that VA did not always ensure key stakeholder involvement,” the report says.

The report notes that the VA’s priorities have shifted to focus on patient care during the coronavirus pandemic. With resources and attention on front-line staff, the EHR roll out was delayed in its first go-live locations in Washington state. It remains unclear what the current delay will mean for future implementation of the program.

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