GAO tells VA to stop rollout of $16B EHR program, but the VA ‘doesn’t plan to’

The George E. Wahlen VA Medical Center in Salt Lake City. (Veterans Health Administration / Flickr)

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Editor’s Note: this story has been updated with comment from the VA

The Government Accountability Office has recommended that the Department of Veterans Affairs stop work on its new electronic health record (EHR) modernization program to conduct “critical” tests before launching at any more medical centers.

The EHR system has faced critical shortfalls and the VA hasn’t completed tests that could result in the failure of the system at the heart of the 10-year, $16 billion modernization program, the GAO states in a report released Thursday.

The system is currently live at a Spokane, Washington medical center with no major reported issues. But as the program continues to be rolled out, the VA’s new health care IT system could falter, the GAO report cautions. Thus, the GAO recommends that the VA “postpone deployment of its new EHR system at planned locations until any resulting critical and high severity test findings are appropriately addressed.”

While the VA responded to the report’s findings by “concurring in principle,” it told FedScoop that it doesn’t plan to stop the rollout.

“The Department of Veterans Affairs (VA) does not plan to stop the launch of VA’s new electronic health record system,” the VA said in a statement. “VA appreciates the opportunity to review the recent Government Accountability Office (GAO) report regarding the progress of VA’s Electronic Health Record Modernization (EHRM) program and the disposition of test findings in relation to subsequent deployments.”

The GAO had a stark warning for VA if it doesn’t properly test and evaluate the system.

“If VA does not close or appropriately address all critical and high severity test findings prior to deploying at future locations, the system may not perform as intended,” the report warned.

However, the VA said that its current rate of testing and risk mitigation strategy will suffice.

While the GAO doesn’t have the grounds to force the VA to do anything, its reports are used by lawmakers who can censure the department leadership in congressional hearings and require them to take action.

The VA apparently disagreed with some of the specifics in the GAO recommendations. After reviewing a draft version of the report, the VA asked the GAO to change some of the report’s language to soften its negative tone.

“Specifically, in the title [Office of Electronic Health Records Modernization] recommends changing the phrase ‘…but Subsequent Test Findings Will Need to Be Addressed’ to read ‘..and Test Findings are being Addressed,'” the report states.

GAO declined, saying its “recommendations are appropriate, as presented.”

At the time of the first “go-live” in October, congressional aides had concerns with the launch. One told FedScoop at the time the VA was only “5 percent” ready. The next leg of the rollout is scheduled to be at the Puget Sound Health Care System in the fourth quarter of fiscal 2021.

Despite congressional and GAO concerns, the VA remains confident in the systems it developed and its processes for dealing with future bumps in the road.

“VA has made significant progress over the last few months and we are well-positioned to continue moving forward while minimizing impact to providers and Veterans,” the VA told FedScoop. “VA is taking every precaution to deliver a safe and effective system for our clinicians and users and remains committed to getting this right for our Veterans.

The EHR system has faced previous delays due to inconsistencies in system performance and a need for more testing. VA staff leading the EHR program told FedScoop in October at the launch “we are getting positive comments,” despite some “usual jitters” among the staff about using the new technology.

The Department of Defense is also migrating its electronic health records system to the same Cerner Millennium cloud-based platform so that it can be linked to the VA system for the seamless transfer of records when service members retire.

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Department of Veterans Affairs (VA), electronic health records (EHRs), Government Accountability Office (GAO), MHS GENESIS
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