VA officials said the initial deployment was delayed after clinicians asked to be trained on a full system instead of a minimum viable product.
The first deployment of the Veterans Affairs Department’s new electronic health records system has been rescheduled for July, four months after the original go-live date.
VA had planned to launch the first instance of its new Cerner Millennium platform at Mann-Grandstaff VA Medical Center in Spokane, Washington on March 28. Once fully operational, the system is ostensibly designed to be interoperable with the Defense Department’s MHS Genesis EHR system, also developed by Cerner as part of the Leidos Partnership for Defense Health.
However, on Feb. 10, VA leadership announced that go-live would be delayed, offering few details on the cause or new timeline.
During a hearing Thursday held by the House Committee on Veterans Affairs, VA Secretary Robert Wilkie confirmed the new go-live date will be sometime in July, though he declined to offer a specific date.
In a separate hearing Thursday before the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies, VA Assistant Secretary for Enterprise Integration Melissa Glynn offered details on the new timeline, including additional capabilities that will now be deployed ahead of schedule.
First, Glynn shared insight into the reasoning behind pushing the initial deployment.
According to Glynn, the first users to start training on the new system reported frustrations over not being trained on a full system, as VA initiated training on a closed instance of the Millennium system that did not include some core functionalities.
“Earlier this month, our clinicians in the field identified and communicated critical requirements and capabilities that must be available prior to user training,” Glynn told the subcommittee. “The secretary listened to this feedback and postponed training so that we will bring the system closer to 100% complete prior to commencing training.”
Glynn said the system will be fully built-out before the end of March, enabling clinicians at Mann-Grandstaff to train on a full system.
Another core component of the larger EHR system still in development is the Joint Health Information Exchange, a shared system that allows physicians from the Military Health System and VA to seamlessly share patient records.
Glynn said the exchange is on track to be up and running by early April “at the latest” and will connect all VA and DOD medical sites. She also cited an ongoing pilot for a new scheduling system—also developed by Cerner—at the medical center in Columbus, Ohio. That program is also on schedule to deploy in April.
While medical center staff will have to wait a little longer for the new EHR system, it will come with additional capabilities that originally were not intended to deploy until the fall, Glynn said.
“These include online pharmacy refills, appointment check-in kiosks, telemedicine and other capabilities intended to improve the veteran experience,” she said. “Our revised go-live date allows us to include additional capabilities intended to enhance user adoption and improve productivity and efficiency for our field staff and, as mentioned, enhance the veteran’s experience.”
Despite the delay to the first deployment, John Windom, executive director of VA’s Office of Electronic Health Record Modernization, told Congress not to expect any additional delays going forward.
“I’ve been reviewing various versions of that schedule and we stay within the [10-year] deployment schedule that was identified by the contract at inception.”
Windom added that the capabilities being deployed and infrastructure improvements being made over the next months and years will lead to increasingly rapid deployments in the future.
“We do not expect to have a cascading effect on the schedule” due to this initial delay, Glynn said.
“My issue is not that we have a necessary delay,” Subcommittee Chair Debbie Wasserman Schultz, D-Fla., said Thursday. “It’s a $16 billion project that needs to be implemented correctly and safely from the beginning and we do not want to compromise patient safety in order to meet an arbitrary deadline.”
However, Wasserman Schultz took issue with VA’s lack of foresight, particularly when it came to the iterative training program.
“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,” she said. “This iterative training process pointed to as the problem is specified in the contract. … This was a known process that was in the plan for implementation and the go-live process, all the way through from the beginning. None of the challenges that have arisen should have been a surprise—least of all to Congress.”
Responding to anger voiced by fellow committee members—most notably from House Appropriations Chair Nita Lowey, D-N.Y.—Wasserman Schultz said Congress will be imposing a new level of accountability on this program.
“We’re at the point now where we have to replace outrage with accountability. And that accountability is going to need to go into this bill,” she said, referring to fiscal 2021 appropriations.
Glynn and Windom confirmed that VA will supply the committees with a full, revised schedule by March 10.