The Department of Veterans Affairs renegotiated its contract with Oracle Cerner to beef up accountability for tech glitches and patient safety issues with its beleaguered electronic health records project.
The renegotiated contract "dramatically increases" VA’s ability to hold the technology company to account for the system’s performance, including reliability, responsiveness and interoperability, according to a statement from Dr. Neil Evans, the VA's acting program executive director for the Electronic Health Record Modernization project.
"We believe that this new contract gives VA the tools we need to hold Oracle Cerner accountable to deliver an EHR that will meaningfully improve Veterans’ health outcomes and benefits. The system has not delivered for Veterans or VA clinicians to date, but we are stopping at nothing to get this right – and we will deliver the efficient, well-functioning system that Veterans and clinicians deserve," Evans said in the statement.
"This new agreement reflects Oracle's commitment to Veterans’ health care as well as complete confidence in our technology and our partnership with the VA to deliver an EHR that far exceeds the expectations of users," said Mike Sicilia, Executive Vice President, Oracle Global Industries, in a statement.
The VA signed a $10 billion deal with health tech company Cerner, now owned by Oracle, in May 2018 to move from the VA’s customized VistA platform to an off-the-shelf electronic health records system. The goal was to align the country’s largest health system with the Department of Defense, which has already started integrating Cerner’s MHS Genesis system.
The VA has obligated about $9.4 billion on the EHR modernization program since fiscal 2018,
The Oracle Cerner Millennium EHR system originally estimated to cost $10 billion and later revised to $16.1 billion, could increase to more than $50 billion in 28 years, a military new site, Stripes.com reported.
Software giant Oracle closed its nearly $30 billion deal to acquire Cerner last June and inherited the company's VA tech project and is working to fix the problem-riddled system. VA has spent roughly $5 billion of taxpayer money to implement the Oracle Cerner EHR system at five of 171 medical centers, where it has badly disrupted operations for veterans and VA providers, according to federal lawmakers.
The Oracle Cerner system was first launched at Spokane’s Mann-Grandstaff VA Medical Center and several Inland Northwest clinics in October 2020.
Federal lawmakers have serious and growing concerns about patient safety issues related to the new medical records system.
In October, the VA announced it would delay the rollout of the Oracle Cerner EHR system at VA Puget Sound Health Care System until after June 2023. The agency then announced last month it was indefinitely putting all future deployments of the Oracle-Cerner EHR on hold, until it addresses problems at the five VA sites already using the system.
The tech project has been beset by problems and system outages that have contributed to more than 150 cases of patient harm, VA officials have confirmed.
VA officials told lawmakers that flaws with the new computer system had contributed to six incidents of “catastrophic harm,” four of which resulted in the death of a veteran, The Spokesman-Review reported.
According to the agency, the new contract has been structured as five one-year terms rather than one five-year term and includes a stipulation that the VA will receive larger monetary credits if Oracle Cerner doesn’t meet expectations.
"For example, if these new terms had been in place since the start of the contract, VA would have received approximately a 30-fold increase in credits for the system outages," Evans said.
Under the new contract, the tech company must now meet 28 performance metrics including a higher standard for reliability and uptime. The performance metrics Oracle Cerner will be evaluated on include minimizing system outages, incidents and interruptions, quickly and reliably resolving help tickets and clinician requests and improving interoperability with private sector providers.
"These new accountability measures will be critical as we focus on improving system reliability and performance at the five sites that currently use the new EHR, as part of the larger program reset announced in April. Specifically, the amended contract lays the groundwork for VA and Oracle Cerner to resolve the EHR issues identified by the “assess and address period” and optimize EHR configuration for future sites," Evans said in a statement.
U.S. Senator Patty Murray (D-WA), Chair of the Senate Appropriations Committee and the VA Subcommittee, and a senior member of the Senate Committee on Veterans Affairs, has been conducting oversight on the flawed EHR rollout in Washington state and praised the stronger contract.
“It’s important to see that this renegotiated contract increases VA’s ability to hold Oracle Cerner accountable on key performance markers and hard metrics—something the contract negotiated under the Trump Administration severely lacked," she said in a statement. "Under the new contract, Oracle Cerner will be penalized for failing to meet expectations on system reliability, responsiveness, and interoperability with other healthcare systems and applications. And importantly, instead of another five-year term, the renegotiated contract is for five one-year terms—providing VA with more frequent opportunities to review progress and renegotiate."
Lawmakers have grown increasingly frustrated with the VA project. Top Republican lawmakers had been ready to pull the plug on the troubled health IT project unless significant improvements were made to fix technical glitches.