Chairwoman Wasserman Schultz Statement at Hearing on VA’s Electronic Health Record Modernization Implementation
Congresswoman Debbie Wasserman Schultz (D-FL), Chair of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Subcommittee, delivered the following remarks at the Subcommittee's oversight hearing on implemenation of the VA's Electronic Health Record Modernization:
Today we welcome Dr. Melissa Glynn, the Assistant Secretary for Enterprise Integration at the Department of Veterans Affairs, Dr. Richard Stone, the Executive in Charge for the Veterans Health Administration, and Mr. John Windom, the Executive Director of the Office of Electronic Health Record Modernization.
The focus of this hearing is to discuss VA’s implementation of a modernized, interoperable Electronic Health Record system with the Department of Defense.
VA is requesting $2.6 billion for the Office of Electronic Health Record Modernization, which is $1.1 billion above last year’s enacted level of $1.5 billion. The huge increase in cost is requested to support the full implementation of EHRM at seven facilities in VISN 20 and preparing facilities for deployment at an additional twenty-four sites in VISNs 22, 21, and 7. This schedule assumes the three Initial Operating Capability (IOC) sites will be deployed this year, in fiscal year 2020.
Up until the end of last August, we heard nothing but good news stories on VA’s side of implementing the shared electronic health record system with the Department of Defense. We heard how VA was hosting workshops with clinicians all over the country to make sure there is clinician buy-in, and that the end product would be what clinicians want and expect to receive.
We heard how VA and Cerner were working through developing all of the capabilities and interfaces needed to deploy the system at the IOC sites in Washington State, and that it would “go-live” on time, on schedule, and on budget.
And then, at the end of August 2019 – and I believe I can speak for all of my colleagues – we were extremely disappointed and surprised to find out about a delay at the Seattle and American Lake IOC locations from news outlets instead of from the VA.
Since then, everything was supposedly going well, and the deployment at Mann-Grandstaff was still going to “go-live” on time in March 2020. However, a little over two weeks ago, Secretary Wilkie called me to let me know there will now also be a delay at Mann-Grandstaff because capabilities were not ready, and training was not going well.
In a nutshell, this means that the entire IOC deployment will now be delayed.
Let me be clear here, my issue is not with a necessary delay. This is a $16 billion project that needs to be implemented correctly and safely from the beginning. I do not want to compromise patient safety in order to meet an arbitrary deadline. We want to be thoughtful in execution and get it right from the beginning.
On behalf of my colleagues and more importantly, the veterans we represent, I do expect and demand better communication from VA on ongoing issues regarding EHRM implementation. Despite quarterly briefings, we are not getting accurate and timely information. The status quo is completely unacceptable.
There also needs to be better communication between the Veterans Health Administration, Office of Electronic Health Record Modernization, and Cerner. My understanding is that VHA clinicians did not respond well to the iterative training and development process. Clinicians want to be trained on a fully developed system. That is perfectly reasonable, and we want to make sure that we have full clinician buy-in to ensure a successful implementation, but this is an issue that should have come up well before one month before the go-live date at Mann- Grandstaff if all parties were communicating effectively with each other. Afterall, the iterative training process pointed to as the problem is specified in the contract. This was foreseeable and should have been anticipated and dealt with.
So, today I want to discuss what the IOC delay means for VA’s electronic health record modernization across the board – its funding implications, future site deployments, leadership vacancies, and communication with Congress.