VA delays go-live of new health record software at Boise medical center

VA Secretary Denis McDonough testifies at a Senate hearing in December 2021.

VA Secretary Denis McDonough testifies at a Senate hearing in December 2021. Drew Angerer/Getty Images

A new third-party cost estimate of the Veterans Affairs health record rollout prepared for Congress suggests that the total cost of the program could exceed $50 billion.

The Department of Veterans Affairs scrubbed a scheduled go-live of its new commercial electronic medical record system in Boise, Idaho, that was set for this Saturday.

The delay comes amid fallout from a highly critical watchdog report that identified a routing issue in the system in which improperly addressed orders vanished into an “unknown queue” that clinicians did not know about.

VA Secretary Denis McDonough confirmed the delay at a Wednesday press conference.

Separately, the leader of the project told lawmakers at a Senate hearing on Wednesday that the decision was made that day, in consultation with the leadership of the Veterans Health Administration, officials at the Boise site and others.

“We made the decision that the system wasn’t in a place -- because of latencies as well as pieces that aren’t in place – that we could have a successful deployment,” said Terry Adirim, program executive director of VA’s Office of Electronic Health Record Modernization Integration Office. 

Also at the hearing, VA chief information officer Kurt DelBene said under questioning that Oracle Cerner has not consistently hit the 99.9% uptime that was called for under the contract. DelBene said there were “several months where they weren’t meeting that ‘three-nines’ reliability.”

In response to questions, DelBene said that there are financial impacts to the vendor for not meeting the reliability demands called for in the $10 billion contract VA signed in 2018 for a 10-year implementation of the software. 

Outages and service degradations have been a regular feature of the new system since it went live in October 2020 in the Mann-Grandstaff Medical Center in Spokane, Washington. Officials at the hearing reported 24 outages and 24 service degradations across the five systems where the Oracle Cerner health records software is currently live. 

At his press conference, McDonough reiterated earlier comments that his confidence in the system was “shaken.”

Additionally, a new cost estimate provided to Congress by the Institute for Defense Analysis and obtained by FCW suggests that the true cost of the program is more than double the $16 billion originally budgeted for the software, infrastructure upgrades and change management and training associated with the 10-year deployment of the health record system.

IDA estimates that it will take 13 years before the new system is online across all VA clinical facilities and that the initial implementation will cost $38.9 billion. Additionally, IDA estimated that with sustainment costs, VA will end up paying $56.1 billion over 20 years to modernize and maintain its electronic health record.

“At this point, I have serious doubts about whether this project should continue, even if the fatal flaws at the initial rollout sites are fixed,” said Rep. Mike Bost (R-Ill.), the ranking member of the House Committee on Veterans Affairs, in an emailed statement.

At the Senate hearing, Adirim told lawmakers that VA was beginning contingency planning for the possibility that the deployment schedule stretches beyond the planned 10 years, but said that VA was for now sticking to the original timeline. She said under questioning that as a “wild guess” the VA might need an extra one to two years, but added that she believed that as VA scaled up deployments, it would be able to pick up the pace.