Ranking Member Wasserman Schultz Statement at Department of Veterans Affairs Implementation of the Electronic Health Record Modernization Initiative Hearing

Congresswoman Debbie Wasserman Schultz (D-FL), Ranking Member of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Subcommittee, delivered the following remarks at the Subcommittee's Department of Veterans Affairs Implementation of the Electronic Health Record Modernization Initiative Hearing.

Good morning. Thank you, Chairman Carter for yielding, and for calling this important hearing.

And I would like to welcome our witnesses today.

Thank you for being here.

The electronic health record modernization program started in 2018, and it is supposed to be a 10-year, $10 billion contract with now Oracle Cerner, plus an additional $6 billion for program management and infrastructure, for a total cost of $16 billion.

We are now finishing up the fifth year of the program. Despite having appropriated over $10 billion in total, including more than $5 billion for the contract, we only have five sites to show for it.

We are more than halfway through funding the contract with Oracle Cerner and halfway through the original expected timeline, and we have barely made a dent in the rollout of the system nationwide.

Per the original deployment schedule that VA built its cost estimates around, the new electronic health record system should have been deployed at close to 70 sites by now.

Now, I want to be clear – I do not believe in pushing out a system before it's ready.

I think it is prudent for VA and Oracle Cerner to hit pause and fix the issues at the five sites where the new EHR system is already deployed and get that right before launching more sites.

But let me be clear – you have to get this right.

When the Reset is over, the expectation and necessity is a fully functional system that can deploy to the remaining 166 sites.

The expectation and necessity is no patient safety issues, no unplanned system outages or degradations, and successful end user adoption of the system.

We need a health record system that works and that clinicians are excited to use. It should be easy to navigate and save them time so they can prioritize patient care.

I hope we can see efficiencies in the deployments so we can make up for lost time and deliver the new system that seamlessly transitions the single electronic health record from DOD to VA and is interoperable with the community – promises we have been making to veterans for decades.

DOD has been relatively successful – they have deployed to all domestic sites and are planning to deploy overseas next month. While DOD has hiccups, they seem to have finally hit their stride.

DOD has done it, and I know VA will do it too.

I hope to spend this hearing getting a better understanding of where we are in the Reset – what issues have been fixed and what issues remain.

I would like to get a better understanding of where we are financially – VA is adding interfaces, workflows, and capabilities outside the original scope of the project, and that is going to cost more money.

The saying goes, if you've seen one VA, you've seen one VA – every medical center is different. One of the reasons why so many people like the current, outdated Vista system, is because it has been so customizable to the individual needs of each facility.

If we wanted 130 separate systems, we would keep Vista.

But that is not the goal of one seamless electronic health record, and it is important that we do not go down a path of too much customization to VA's system.

If you've seen one VA, you've seen one VA is not going to be the mantra for EHRM.

I want to get a better understanding today how you are reigning in the number of workflows, capabilities, and interfaces. As I've mentioned, the point of EHRM is to have one system that is completely seamless between DOD and VA.

VA is not DOD, and there is definitely a need to make changes to support the different population that VA supports and the wide variety of services VA provides, but it must be balanced.

If we customize too much on the VA side, not only is it going to be more technologically challenging to develop, but it is also going to cost more, and it is going to defeat the purpose of the system – we want a repeatable model that can be deployed at every VA site without special customization at every location, which will slow down the deployment.

I know we are not going to solve every problem with VA's electronic health record system today, but I hope we can have a candid conversation about where things currently stand and how we are going to make this system successful and improve the lives of our veterans.

Thank you, and I yield back.