Members of Congress are not happy with recent budget shortfalls at the Department of Veterans Affairs (VA) as the budgets for its IT modernization projects continue to swell, with one lawmaker calling on the agency to “abandon” its electronic health record (EHR) system immediately.
The VA informed Congress in July that the Veterans Health Administration (VHA) is facing a $12 billion shortfall in fiscal year (FY) 2025 for medical care.
“The lack of VA accountability is happening as VA has completely lost control of its budget and has IT projects ballooning by tens of billions of dollars,” House Committee on Veterans’ Affairs Chairman Mike Bost, R-Ill., said during a hearing today. “That includes the Digital GI Bill, Financial Management Business Transformation, and the electronic health record system.”
The VA Office of Inspector General (OIG) issued a report last month that revealed poor planning by the VA had more than doubled the cost of its education benefits system, known as the Digital GI Bill platform.
As for the VA’s EHR system, the agency’s Electronic Health Records Modernization (EHRM) program – conducted in partnership with contractor Oracle Cerner – has a current budget of $16 billion. However, after facing ongoing delays, the VA requested an independent life cycle cost estimate on the program from the Institute for Defense Analysis in 2022, which said it exceeds $50 billion.
“Absolute disaster of a pick,” Rep. Greg Murphy, R-N.C., who is a physician himself, said of the VA’s decision to work with contractor Oracle Cerner. “Cerner should be abandoned today. Six out of 160 sites after 10 years?”
“You guys need to stop Cerner tomorrow,” he stressed. “It is not a system that is meant for the VA – a medical system the size of this. This is a mistake that for 10 years money has been poured into, and you literally have less than 4 percent of the whole system on Cerner now, and its interoperability with other large systems is paltry. This is a huge problem, and why will the VA not recognize they screwed up 10 years ago and fix it today? It will cost an outlay of money, but it will actually deliver care to veterans that need it.”
The VA’s EHRM program is currently in the middle of a “program reset,” while the VA and contractor Oracle Cerner focus on improvements at the six sites where the EHR system is currently deployed. The VA said it plans to resume deployments at the other sites in FY2025.
VA Under Secretary for Health Shereef Elnahal told Rep. Murphy that the VA is “dedicated to trying to get this right,” as it resumes deployments.
“The initiative has not gone as it should have been. I fully admit that, and it’s been an effort across now two administrations to try to get it right, but we are now poised to be able to start deployments again,” Elnahal said.
Nevertheless, Rep. Murphy expressed his disappointment that the VA may only add five new EHR systems next year when there are 160 VA sites.
“This is wrong. There’s a time when you pull the string and say, ‘Yep, we made a wrong decision. We need to cut the line and do something different,’” Rep. Murphy said. “It’s going to be another 10 years. That’s absolutely wrong, and then every system will be out of date, and it will cost hundreds of millions of dollars, if not billions of dollars, to update this. It is an antiquated system. It cannot fit the VA’s needs, and you guys need to change it, period.”
“I actually know what I’m talking about on this. This is not political rhetoric. This is an actual physician taking care of patients that the information is needed,” he concluded. “It demonstrates the inefficiency and the bureaucracy of the VA in not understanding that this is a wrong path and fixing it.”
Elnahal committed to being more transparent with Rep. Murphy on the EHRM program, saying, “I’m not belying at all your experience as a physician and a provider, but my commitment to you is to keep you posted on making this better.”
Rep. Matt Rosendale, R-Mont., chairman of the House VA Subcommittee on Technology Modernization Oversight, added a point of clarification, noting that Oracle acquired the Cerner system.
“Cerner has been purchased by Oracle. So, Oracle is replicating and duplicating the exact same mistakes that Cerner did and is continuing to collect billions of dollars,” Rep. Rosendale said. “A change has to be made.”
“I do appreciate all of the conversations that we’ve had with the VA about establishing some matrix that Oracle has to abide by in order to keep this moving forward,” he added. “And I think that we all can agree that is the best path.”
