Tester wants VA to renegotiate electronic health records contract

BY: BEN LEONARD | 03/15/2023 06:09 PM EDT

Sen. Jon Tester (D-Mont.), chair of the Senate Veterans’ Affairs Committee, on Wednesday said the VA should renegotiate its contract with Oracle Cerner, the vendor managing a mistake-ridden electronic health records system at VA medical centers.

Despite Oracle Cerner’s progress in recent months, Tester said the government needs further guarantees that it can correct problems that have put veterans’ lives at risk and ballooned cost estimates.

The VA should seek a new deal by the time the current one expires in May and insist on discounted prices and “severe” penalties for “poor performance,” Tester said at a committee hearing.

“If Oracle won’t agree to those terms, then the VA should be prepared to roll up their sleeves and negotiate an entirely new contract,” Tester said. “We need to know exactly where the hell we’re at, where we’re going, what it’s going to cost and when we can look for timely delivery of a thing we’ve been talking about here for 20 years.”

Why it matters: VA’s electronic health records system rollout began in 2018 with an estimated price tag of $10 billion over a decade, but a recent estimate from the Institute for Defense Analyses commissioned by the VA says it will cost $50 billion over 28 years.

Oracle Cerner has disputed that estimate.

Because of the safety issues and glitches, Oracle Cerner has only rolled out the system at a small portion of the VA’s 171 medical centers. VA has paused further rollouts until June.

VA told Congress Tuesday that six additional veterans were possibly hurt by system problems, Tester said, and four died. It’s not clear what the problem was. The system has previously misrouted orders for prescriptions and requests for exams, causing delays in care.

VA and Oracle’s response: Neil Evans, acting program executive director of the VA’s Electronic Health Record Modernization Integration Office, said the agency is committed to patient safety and is working aggressively with Oracle Cerner to fix problems.

“It’s important to take the time now to get things right and provide a strong foundation for an accelerated deployment schedule later,” Evans said.

Oracle Executive Vice President Mike Sicilia said that the company has been making “dramatic improvements,” but acknowledged there is still more work to do.

Oracle bought the electronic health records vendor Cerner, which won the VA contract in 2018, last year.

“I’m more optimistic than ever that we are now on the right trajectory and we can get this program on track, on schedule and on budget,” Sicilia said.

The Government Accountability Office, which monitors the executive branch for Congress, issued 10 recommendations Wednesday for the VA to improve system implementation. Evans said that VA will work to implement them.

What’s next: Despite his concerns, Tester stopped short of calling to terminate the project, which aims to modernize the VA’s existing electronic records system to better integrate care with the Department of Defense, the Coast Guard and participating community care providers.

Nonetheless, some House Republicans, including Veterans’ Affairs Chair Mike Bost (R-Ill.) and Veterans’ Affairs Technology and Modernization Subcommittee Chair Matt Rosendale (R-Mont.), have floated pulling the plug.

Bost also introduced legislation that would prevent VA from rolling out the system at new sites before there are “significant improvements.”

Sen. Jerry Moran (R-Kan.), the Veterans’ Affairs Committee’s ranking member, said he’s concerned that the system may be “sleepwalking toward an extremely destructive result.” He said he needed further assurances to justify more spending.