VA reforming EHR deployment following 12-week review

The Department of Veterans Affairs will restructure how it implements its electronic health records modernization program following a 12-week strategic review of the $16 billion program, Secretary Denis McDonough told lawmakers Wednesday.

User training is a major theme of many of the changes that need to be made to improve the way clinicians and patients use the new system, McDonough said during a Senate Veterans’ Affairs Committee hearing.

“I think that there is just no doubt the training was wanting,” McDonough told the

Included in those changes will be the introduction of new virtual testing environments — “sandbox” deployments of purely technical changes to improve underlying IT infrastructure that shouldn’t impact user experience. While the updates will bring fixes to some technical aspects, McDonough said they are mostly programmatic improvements.

Training and testing issues led to a delay in the initial go-live of the system in Spokane, Washington, in February and were the subject of multiple government watchdog reports, including one that sounded the alarm on potential system failure without adequate testing.

McDonough also reiterated the VA’s commitment to sticking with its prime contractor, Cerner, which has been working on developing cloud-based overhauls for both the Department of Defense’s and VA’s health IT systems.

The secretary said the continued rollout of the EHR across the nation would be dependent on testing and the ability for the facilities to make progress on deploying the system, rather than based on their location as was the initial plan.

“You will see us pursue a surge of activity in the coming weeks and months, intently focused on veteran experience, patient safety and employee engagement. Specifically, VA will pursue technical-only (“sandbox”) deployment of Cerner technology at previously planned sites in Veterans Integrated Service Networks (VISNs) 10 and 20 – ensuring technical readiness without affecting veterans or frontline clinical employees,” McDonough said in his prepared opening statement.

There will also be new data teams that will work to integrate databases associated with the new system. The VA’s EHR system is eventually supposed to seamlessly connect with the DOD’s MHS Genesis modernization program.

“However, gaps remain in our ability to govern and manage data between the two EHRs and with DOD to ensure seamless veteran and employee-centric information sharing and provision of managed, trusted data,” he said, adding that a clinician told him that most of the data integration happens in workers’ heads, not on the computer systems they use.

By the end of the year, the VA will also publish a data strategy specific to making EHR data more interoperable, McDonough revealed.