VA, Oracle's Cerner agree on renegotiated health records contract

Long, costly wars not the only thing US government good at getting stuck in

In a bid to find an exit strategy for its electronic health record quagmire, the US Department of Veterans Affairs has renegotiated its contract with Cerner parent Oracle to hold it accountable for a messy EHR deployment after pausing the rollout last month.

In an announcement [PDF] viewed and shared by Bloomberg Government, the VA said its new contract with Oracle-Cerner adds 28 additional performance metrics across areas including reliability, responsiveness and interoperability with other EHR systems and applications.

Along with those new performance metrics, the renegotiated contract also stiffens monetary penalties Oracle has to pay to the VA if it fails to meet expectations. "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," the VA said in its announcement. 

Finally, the renegotiation also amended the terms of the contract from a single five-year deal to five one-year terms "so VA will have the opportunity to review our progress and renegotiate again in a year if need be," the VA said. 

Why is this needed?

For those not keeping up on the saga of the VA trying to replace its 39-year-old in-house VISTA EHR platform, the agency signed a deal in 2015 with Cerner to upgrade its systems, with test deployments beginning in 2020.

By late last year it was apparent the system simply wasn't working, with repeated downtimes, misrouted requests and other issues calling the $10 billion contract into question and leading to the department pausing future rollouts in October. When the VA announced the hold it said it would consider restarting Cerner deployments this June.

Last month, the VA called an indefinite halt on future deployments of Cerner at its facilities, calling for a reset of the program with a new focus on "fixing what's wrong, listening to those we serve, and laying the foundation for a modern electronic health record that delivers for Veterans and clinicians," said VA secretary Denis McDonough.

Just last week, the House Committee on Veterans' Affairs held a hearing to examine pharmacy issues at the VA due to Cerner, which witnesses said had caused medications to not be delivered, the wrong prescriptions to be sent and mail-order medication being flagged for pickup. One VA facility said it had to quadruple pharmacy staff to keep up with the workload foisted on it by Cerner; Oracle said the five VA facilities using Cerner were sending medications to veterans "at the same rate" as they were under VISTA.

Responding to the news of the new contract, House Committee on Veterans' Affairs Chairman Rep. Mike Bost (R-IL) and Subcommittee on Tech Modernization Chair Rep. Matt Rosendale (R-MT) said in a statement that they remain skeptical about whether the new terms would lead to positive changes.

"This shorter-term contract is an encouraging first step, but veterans and taxpayers need more than a wink and a nod that the project will improve. We will continue closely overseeing this effort," the pair said.

Their Senate Veterans' Affairs Committee counterpart, Chairman Jon Tester (D-MT), expressed similar reservations about the contract change, saying it was a step in the right direction toward making the VA's new EHR system functional, but not all that's required. 

"This is just the start of what's needed to get this program working in a way deserving of our veterans and taxpayers. That's why I'll keep holding VA and Oracle Cerner's feet to the fire," Tester said.

The Montana senator was part of a trio of senators who in March introduced a bill to completely restructure the VA's EHR overhaul program, which has since been stuck in committee.

In a statement sent to The Register, Mike Sicilia, Executive Vice President, Oracle Global Industries, said: "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." ®

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