Faulty veteran health record system needs urgent fix
This op-ed originally appeared in the Dallas Morning News
Congress needs to address ongoing problem that is causing deaths.
The Department of Veterans Affairs recently admitted that four veterans died due to Oracle Cerner electronic health record management system failures. The multibillion-dollar system created to protect and support veterans has slowly proved itself unable to accomplish the task.
Over the past several years, Congress has made significant strides to support veterans through the MISSION Act, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, and the benefits expansions in the PACT Act. Now, it is time for congressional leaders to focus on the seemingly unending systemic problems of the electronic health record management system.
To be clear, the system is a necessary program for transitioning service members and veterans to ensure a smooth transition of their medical records between the VA and the Department of Defense. Since the 1980s, the VA has been using the Veterans Health Information Systems and Technology Architecture, also known as VistA, which is now so outdated the VA doesn’t even have enough programmers certified to work on the system. VistA includes 130 separate systems implemented at autonomous medical centers across the country, leaving room for significant redundancy.
Unfortunately, since its inception, the amount of backlog disability claims, delayed response times, and copious complaints have only continued to pile up — and the more behind the system becomes, the less support is accessible to veterans.
In 2018, Congress funded a $10 billion contract with Cerner, which merged to become Oracle Cerner in June 2022. The electronic health record management initiative leverages Oracle Cerner technology and coordinates with VA medical facilities and the Department of Defense to revitalize the system, ensuring functionality for veterans and their health care providers. But little progress has been made throughout the program — from its start, through the merger with new management, until now.
The VA’s Inspector General has reported an underestimate of $2.6 billion in the cost of upgrades — that is after years of being over budget. There has been an astonishing lack of answers to the problem other than the two extremes: increase funding, or cancel the contract entirely and re-bid it. But as with most federal policies, it is not that simple.
As previously mentioned, an effective electronic health record management system is necessary, and Congress has already sunk billions of dollars in its successful implementation, giving the VA the tools it needed to update the outmoded and insufficient system. Despite this, it has continued to present safety concerns for veterans.
For example, inaccuracies within the system resulted in delays in medications, appointments, referrals, and patient test results. Such errors have potentially endangered over 40,000 patients. In addition, a delayed follow-up caused harm to 150 cases. Not only is this unacceptable, but it can and should be easily fixed. Thus, the system has been put on hold until June while the VA seeks to amend these issues and safety concerns for veterans.
In response to the safety issues and a nod towards progress, the VA sent Congress the EHRM Sprint Report identifying 14 “key safety issues” they must address before the most recent hiatus ends. This is a promising move toward providing veterans with an accurate and safe medical record system. But the rollout must not be rushed until the safety concerns have been solved.
This is a common consensus among veterans: in a recent poll by Mission Roll Call, 83% of veteran respondents said the VA’s Oracle Cerner project should remain paused until the system is improved. One thing is clear — neither getting rid of the system entirely nor throwing more funding at it will solve the problem.
Veterans navigate many obstacles in transitioning to civilian life, including enrolling and obtaining veterans benefits, homelessness, utilizing their VA home loan, the backlog of VA benefits appeals, and accessing health care (including mental health services). Leaders have the opportunity to fix the electronic health record management system and take one significant hardship off of veterans’ plates. They must do so.
The common refrain that “the VA is doing everything they can” is becoming harder to believe with repeated issues in the expansion of the electronic health record management system. Until we address the perpetual problems that are halting veterans from receiving the care they need via contractor accountability or within the EHRM program of record itself, we will fight this same bureaucratic battle. Taxpayers and veterans will continue to pay the price.
Dallas-Fort Worth native Cole Lyle is the executive director of Mission Roll Call, a former policy adviser in the U.S. Senate and U.S. Department of Veterans Affairs, and U.S. Marine Corps combat veteran. He wrote this column for The Dallas Morning News.