Indian Health Service aims to avoid VA’s pitfalls while adopting computer system that has hampered Northwest veterans’ care

WASHINGTON – The Indian Health Service plans to adopt a computer system developed by the company behind the software that has hobbled Spokane’s veterans hospital since 2020, but the federal agency that provides care to about 2.8 million tribal members says it will avoid the Department of Veterans Affairs’ stumbles.

On Sept. 12, the IHS announced facilities in the Oklahoma City area as the pilot site for the system, which it calls PATH EHR, short for “Patients at the Heart,” plus the acronym for “electronic health record.” In response to questions from The Spokesman-Review, the agency said the initial launch is expected in summer 2026.

In contrast to the $10 billion, sole-source contract the VA awarded in 2018 to the company now called Oracle Health, the IHS selected the same electronic health record system through a competitive acquisition process. Unlike the VA, the $2.5 billion IHS contract will be managed by another company, GDIT, that will coordinate what is expected to be a decadelong process to transition from an older computer system used to track patient information and coordinate care.

In emailed responses to questions, the IHS Division of Health Information Technology Modernization and Operations said it is “taking a proactive and collaborative approach with modernization efforts,” working with the Defense Department – which was the first to implement the Oracle Health system – and the VA to learn from the other agencies’ experiences.

After the Defense Department began rolling out the system in 2017, first at Fairchild Air Force Base and then at bases in Western Washington, a Pentagon report that found it “neither operationally effective nor operationally suitable” didn’t dissuade the Trump administration from buying the same system for the VA a year later. Spokane’s Mann-Grandstaff VA Medical Center, the initial VA test site, has been hamstrung by errors and design flaws since adopting the system in 2020.

In a statement, the IHS said it plans to avoid those pitfalls by including tribes and urban Indian organizations, such as the NATIVE Project in Spokane, throughout the project. Clinics run directly by the agency, including those on the Spokane and Colville reservations, will adopt the system gradually, while facilities that receive IHS funding but are run by tribes, such as Marimn Health on the Coeur d’Alene Reservation, can opt in to using it but aren’t required to do so.

“One of the central principles of the Health IT Modernization Program is to build and operate PATH EHR with our partners, not for them,” the agency said. “The pilot site and the IHS governance model will support this goal of collaboration and help to ensure that PATH EHR deployment minimizes disruptions to facilities and improves patient care and health care operations.”

The current IHS system is based on the VA’s homegrown electronic health record system, called VistA. In a virtual presentation to VistA developers on Sept. 13, Howard Hays, the IHS chief medical information officer, said the timing of his agency’s decision was influenced by the VA’s transition to Oracle Health, “but we would have done it anyways.”

“The timing was such that it needed to be done, because we are anticipating the VA pulling away from support for VistA over time,” Hays said, explaining that the project’s goal is “enhancing that patient-centered health care because we have a lot more information about the patients.”

Hays said the existing IHS system, which he called a “distant cousin” to VistA after years of divergence, differs between IHS facilities and doesn’t easily share data with commercial health systems. That so-called “interoperability” has been a problem in the VA version of Oracle Health, but Hays said his agency’s system will differ from the versions used by the VA and Department of Defense.

“Is this the same company that is providing the EHR for the VA and DOD? Yes,” he told the VistA developers. “Is it going to be the same EHR? No. It will be a completely different instance and configuration that is designed to support the care provided in Indian County by IHS federal facilities, as well as any interested tribal or urban Indian organization that wants to participate.”

So far, the IHS has not provided a timeline for the Oracle Cerner system’s launch at any sites in the Northwest. Tribes in the region that receive health care directly from the agency include the Spokane Tribe, the Confederated Tribes of the Colville Reservation, the Confederated Tribes and Bands of the Yakama Nation, and several others west of the Cascades.