Despite VA Cerner EHR Modernization Delays, $16B Budget Stands Still

An internal watchdog agency stated that the Cerner EHR modernization (EHRM) project cost would likely rise after several delays, but the VA head of department disagrees.

Several questions have been raised about the overall costs of the projected $16 billion Cerner EHR modernization (EHRM) project; however, Veteran Affairs Secretary Denis McDonough has assured Congress will not need to allot more funding, according to reporting from The Spokesman-Review.

“I continue to believe that we have the budget authority that we need over the life of this project,” McDonough stated in response to a question from The Spokesman-Review. “If we have reason to believe that that’s changed, we’ll obviously go straight to Congress and talk that through with them. … But at the moment, I believe that we have the budget authority we need.”

These remarks by McDonough followed a report released by the VA Office of Inspector General estimating that schedule delays that extend the program will cost nearly $2 billion for each year the project is behind.

The OIG audit team uncovered that the VA lacked a reliable integrated master schedule in alignment with scheduling standards, which increases the risk of missing milestones and further delays EHR implementations.

VA has received much backlash from lawmakers and watchdog agencies regarding the lack of transparency over the cost of the EHRM projects, including a $10 billion contract with Cerner to develop the modernized system and an additional nearly $6 billion for technology infrastructure upgrades.

In 2021, two reports from OIG stated the VA underestimated the total by billions due to poor reporting practices.

In response to the cost inaccuracies, the VA had paused its EHR implementation through the end of the 2021 calendar year to ensure enterprise readiness at the next go-live.

Two years after the rollout was set to begin, the system has only been implemented at just two out of 171 VA medical centers.

Cost inaccuracies are one of many challenges delaying the project. Patient safety issues have also delayed several EHR implementations.

In March 2022, Washington Senator Patty Murray (D-Wash.) called out the VA to delay its planned March 26 EHR implementation in Walla Walla.

This came after an OIG report found dozens of technical challenges regarding the EHR implementation launched in October 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington.

The VA OIG reports found "serious deficiencies and failures" with the Cerner EHR at the VA EHR Modernization (EHRM) pilot site in Spokane.

“VA, and Cerner, need to be completely transparent with Congress and cannot withhold or slow walk information to the Inspector General’s office,” the Washington senator stated. “I’m grateful to the staff who have raised these concerns with my office and the Inspector General—because, without them, we would not know the extent of these patient safety risks.”

Recently, a veteran was hospitalized for heart failure at the Mann-Grandstaff after the Cerner system contributed to a vital medication not being renewed.

VA officials and Cerner executives are scheduled to testify before a House VA subcommittee regarding the issues surrounding its EHR rollout.

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