The Department of Veterans Affairs (VA) announced it has reached an agreement on a modified contract for its Electronic Health Records Modernization (EHRM) program with Oracle Cerner, and said that the latest agreement takes a tougher stance to hold Oracle Cerner accountable for technical fixes to the program whose rollout has been beset with difficulties.
The VA announced the new contract has been renegotiated from a five-year term to five one-year terms, so that the agency can “renegotiate again in a year if need be,” according to Dr. Neil Evans, acting program executive director of the EHRM Integration Office.
“Ultimately, we believe that this new contract gives VA the tools we need to hold Oracle Cerner accountable to deliver an EHR that will meaningfully improve veterans’ health outcomes and benefits,” Dr. Evans said in a statement to MeriTalk. “The system has not delivered for veterans or VA clinicians to date, but we are stopping at nothing to get this right – and we will deliver the efficient, well-functioning system that veterans and clinicians deserve.”
The new contract includes larger fines or “monetary credits” Oracle Cerner will need to pay if it does not meet expectations, increasing the VA’s ability to hold the contractor accountable. The contract includes 28 performance metrics for Oracle Cerner to meet, including outage-free time.
For example, Dr. Evans said if these new contract terms had been in place since the start of the contract, “VA would have received approximately a 30-fold increase in credits for the system outages.”
In addition to minimizing outages, other key areas with stronger performance metrics and expectations include improving responsiveness to help tickets and clinician requests, as well as ensuring interoperability with other healthcare systems and applications.
The VA announced last month that it is pausing all future deployments of its EHRM program – with the exception of one planned for 2024 – while it focuses on improvements at the five sites where the EHR system is currently deployed, as part of a larger program reset.
“These new accountability measures will be critical as we focus on improving system reliability and performance at the five sites that currently use the new EHR,” Dr. Evans said.
“This new agreement reflects Oracle’s commitment to veterans’ health care as well as complete confidence in our technology and our partnership with the VA to deliver an EHR that far exceeds the expectations of users,” Mike Sicilia, executive vice president of Oracle Global Industries, said in a statement.
Senate Veterans’ Affairs Committee Chairman Jon Tester, D-Mont., said the negotiated contract is an improvement, but still called on Congress to pass the EHR RESET Act, which he introduced with Sens. Patty Murray, D-Wash., and Sherrod Brown, D-Ohio.
“I’ve said from day one that the EHRM system has to deliver for veterans, VA medical professionals, and the American taxpayer – and this new contract is a step in that direction,” Sen. Tester said in a statement. “But this is just the start of what’s needed to get this program working in a way deserving of our veterans and taxpayers. That’s why I’ll keep holding VA and Oracle Cerner’s feet to the fire in implementing these changes while we work to pass stronger reforms under my bipartisan EHR RESET Act.”
His legislation would instruct the VA to not move forward with other EHRM deployments at other VA sites until the data at the five existing deployment sites “demonstrates an ability to deliver health care to veterans at standards that surpass metrics using VA’s VistA system or that meet national health operations standards as determined by the under secretary for health.”
That bill is gaining momentum in Congress, as House VA Committee Chairman Mike Bost, R-Ill., and Ranking Member Mark Takano, D-Calif., introduced companion legislation in the House.
Chairman Bost, along with Subcommittee on Technology Modernization Chairman Rep. Matt Rosendale, R-Mont., also released a statement noting that the renegotiation is encouraging, but additional work needs to be done.
“While we appreciate that VA is starting to build accountability into the Oracle Cerner contract, the main questions we have about what will be different going forward remain unanswered,” the lawmakers said. “We need to see how the division of labor between Oracle, VA, and other companies is going to change and translate into better outcomes for veterans and savings for taxpayers.”
“This shorter-term contract is an encouraging first step, but veterans and taxpayers need more than a wink and a nod that the project will improve,” they continued. “We will continue closely overseeing this effort to get veterans and VA staff the fully functional electronic health record they deserve.”