VA announces its new EHR rollout strategy

Efforts to bolster the systemwide rollout in the near future includes stronger leadership and governance.

The Veterans Administration (VA), which had paused the deployment of its new Cerner EHR system in July, is restarting its rollout – with a shift of focus and approach.

The revisions include an updated rollout schedule, under which the deployment will resume in March at VA medical centers in Columbus, Ohio, and Walla Walla, Wash., and continue over the next few years. The VA noted that the schedule could be adjusted further based on a variety of factors, with the head of the list COVID-19 pandemic.

The VA also is focusing on a new, stronger management structure, which is meant to incorporate best practices in communication, risk management, business process, system development lifecycle management and customer experience.

Some of the most significant changes include a substantially strengthened Office of the Functional Champion, and the establishment of two new positions: a Program Executive Director for EHR Integration and a Deputy Chief Information Officer for EHR. The VA has selected Terry Adirim, MD, currently serving as the acting assistant secretary of Defense for Health Affairs, for the PED position. The DCIO has not yet been announced.

The VA is also moving to a new governance structure for the EHR rollout. The VA is establishing an EHR Integration Council that will be better able to receive stakeholder input and ensure more coordinated and timely decision making.

VA had awarded Cerner a sole-source $10 billion contract in May 2018 to replace VA’s existing legacy EHR system, VistA, with Center’s commercial off-the-shelf system, Cerner Millennium. However, the initiative, called the Electronic Health Record Modernization (EHRM) program, has been beset with logistics and cost issues. The first deployment, at Mann-Grandstaff VA Medical Center in Spokane, Wash., encountered myriad problems, some of which affected patient safety.

VA Secretary Denis McDonough ordered a 12-week strategic review of the EHRM program in this past March. The pause was then ordered so that the program could be revamped.

The revised rollout strategy plan, outlined in the VA’s report of its review published December 1,  is intended to “establish additional rigor and oversight” to address and mitigate the challenges encountered during the initial rollout.

Other changes include better training, an enhanced readiness checklist, and the finalization of a data strategy that implements joint Department of Defense/VA data management. The VA also will work to improve the Veteran experience and build confidence at the sites. “We will do everything we can to get electronic health records right for Veterans and our health care staff, with patient safety being the key driver and nonnegotiable,” said VA Deputy Secretary Donald M. Remy in a statement. “I have incorporated the lessons learned I received during my recent meetings with our team at Mann-Grandstaff VA Medical Center in Spokane, Washington, into this new way forward.”

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