Despite ‘full stop’ on flawed health record system, VA will keep using it in Spokane and Walla Walla

WASHINGTON – The Department of Veterans Affairs on Friday announced it would halt future deployments of a troubled computer system linked to patient harm and delayed care, but said the system would remain in use in Spokane and across the Inland Northwest as part of a “reset” aimed at making it safe to launch elsewhere.

The Oracle Cerner electronic health record system, which is intended to replace the VA’s existing system, launched in October 2020 at Spokane’s Mann-Grandstaff VA Medical Center and its affiliated clinics in Coeur d’Alene, Sandpoint, Wenatchee and Libby, Montana. After a delay prompted by problems that emerged in Spokane, the system came to Walla Walla’s VA hospital in March 2022, along with additional clinics in Richland, Yakima, Lewiston and three towns in northeastern Oregon.

Despite reports of the system frequently crashing, mixing up medications and causing dangerous delays in treatment, VA leaders opted to continue the rollout in Columbus, Ohio, and two hospitals in southern Oregon before postponing further launches following a watchdog report that found the system caused harm to scores of veterans. In October, the department notified more than 71,000 veterans that the system may have impacted their health care, and in March VA officials told Congress the system had played a role in the deaths of four veterans.

A press release announcing the “reset” acknowledged the system’s problems, which the VA detailed in a March report. The official newly in charge of the system’s rollout said Friday’s announcement was different from the department’s previous stops and starts, which were never based on clear criteria.

“For the past few years, we’ve tried to fix this plane while flying it – and that hasn’t delivered the results that Veterans or our staff deserve,” Neil Evans, the acting director of the VA’s Electronic Health Record Modernization Integration Office, said in a statement. “This reset changes that.”

On a call with reporters Thursday, Evans said the department would keep flying that proverbial plane in the Northwest and central Ohio because reverting to the old system, which is still in use at nearly all of the VA’s roughly 1,300 clinics and hospitals, would be “really, really difficult.” In addition, Evans said, continuing to use the Oracle Cerner system at the five hospitals where it has been deployed would yield “lessons learned” that could help improve the system.

“We can do that if we continue to use the record,” he said, referring to the Oracle Cerner system. “In fact, this is really doubling down on the importance of the voices of the users at our existing five sites.”

Those voices have grown weary in the two-and-a-half years since the system arrived in Spokane, after former President Donald Trump opted to give Cerner Corp. a $10 billion contract in 2018 to replace the VA’s homegrown system, known as VistA. The tech giant Oracle acquired Cerner in June 2022 for more than $28 billion.

Mann-Grandstaff was given extra staff in preparation for the transition to the new system, which was expected to reduce the number of patients each provider could see in a given day. But a Spokesman-Review investigation in December found that VA leaders have eliminated some of those extra positions in Spokane as they have become vacant, instead of filling them, partly because of a budget crunch worsened by the system’s impact.

In a statement, the executive vice president of Oracle Global Industries, Mike Sicilia, said the company is “proud to continue working together with VA to modernize its Electronic Health Record system.”

Oracle supports the VA’s plan to focus on improving the system’s operation at the current sites, Sicilia said. He pointed to the Defense Department’s rollout with the same system, which began at Fairchild Air Force Base in 2017 and encountered similar problems but is now nearly complete.

The Oracle Cerner system – which is shared by the VA, the Defense Department and the Coast Guard – went down for roughly five hours on Monday, according to internal emails obtained by The Spokesman-Review, leaving health care providers to write notes on paper or type them into a Microsoft Word document.

The VA and Oracle are negotiating a contract extension to take effect after the initial five-year term expires May 16. Evans declined to provide details about the new contract, citing the ongoing talks.

The VA initially estimated the total cost of the project at $16 billion over 10 years, but an independent cost estimate by the Institute of Defense Analyses in October projected that fully deploying the system would cost nearly $33 billion over 13 years.

Evans said the new system is now used by roughly 10,000 clinical users, who provide health care to about 200,000 veterans.

“We’ve heard from Veterans and VA clinicians that the new electronic health record is not meeting expectations – and we’re holding Oracle Cerner and ourselves accountable to get this right,” VA Secretary Denis McDonough said in a statement. “This reset period will allow us to focus on fixing what’s wrong, listening to those we serve, and laying the foundation for a modern electronic health record that delivers for Veterans and clinicians.”