Mrvan Opening Statement for Technology Modernization Subcommittee Hearing on the EHRM Program

Washington, DC - Today, Rep. Frank J. Mrvan, convened a hearing today as the Chairman of the House Committee on Veterans’ Affairs Subcommittee on Technology Modernization entitled Next Steps: Examining Plans for the Continuation of the Department of Veterans Affairs (VA) Electronic Health Record Modernization (EHRM) Program.

A video of the hearing is available here and the text of the opening statement as prepared for delivery is below.

"Good afternoon and thank you for joining us as we continue the Subcommittee’s oversight of the electronic health record modernization program. We are now four years into the 10-year contract, and VA has deployed the full system at two medical centers and the scheduling solution to a third. While I believe that the majority of the system is working as advertised, there are some very real concerns with parts of it, namely the pharmacy and referral management solutions, among others. 

"Earlier this month, the VA Office of the Inspector General released three reports highlighting issues with pharmacy and referral management, as well as how VA and Cerner are handling the issue ticketing process. While we were aware of most of the issues in these reports, I am extremely concerned by the fact that most of them remain unresolved. It’s been a year and a half; we need to understand what’s holding things up. 

"Also earlier this month, we held a roundtable discussion with leadership from the three medical centers. What I heard, loud and clear, is that the pharmacy solution does not meet their needs. It makes both the physicians’ and the pharmacists’ jobs more difficult than it was in the legacy system, and still requires a large number of extra steps and workarounds. Staff shared that they feel the shortcomings of the system introduce an unreasonable amount of risk in their patient care efforts and are putting veterans lives and health at risk.

"This was highlighted by an episode that the Spokane pharmacy director brought to our attention, where a veteran’s heart medication fell off of his record, causing the veteran to run out of medication. I’ve heard that the veteran needed to be hospitalized after a cardiac episode. While I know that this issue is more complex than just an EHR failure, we have been concerned about something like this happening since I first joined the Committee. This type of event is unacceptable, and I expect to hear from VA and Cerner today how they are going to prevent this from happening again.  

"I also heard from front-line staff about the shortcomings of the referral management system. The new workflows have added an enormous amount of extra work, which is dramatically affecting their productivity levels, and more importantly their ability to get veterans access to necessary appointments. Access and wait times are a major issue of concern with VA and this is not making it any better. 

"Additionally, there seems to be a major issue with system instability. We heard from Spokane that there have been a large number of system outages and degradations since their go-live eighteen months ago. There have been issues with DEERS and Oracle databases that have taken the system down, among other things. It’s hard to do your job when the systems you rely on are not working. I also expect to hear from VA and Cerner today about what they are doing to improve system stability. 

"Lastly, I’ve heard that VA has added Seattle, Ann Arbor, and other more complex VA facilities to the schedule for this year, and I am very cautious about this timeline. Given the issues that we’re seeing in Spokane and Walla Walla, I think the risks exceed the benefits, and have seen no indication that the system is ready for the challenges at those facilities. These issues have to be fixed first, and the concerns of the facilities currently using the system need to be addressed. Until these issues are resolved, the Committee cannot support VA going live with Cerner at larger, more complex facilities.

"I appreciate that VA and Cerner are here today to discuss their plans to address these critical challenges."

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