The committee highlighted the significant financial costs associated with the EHR implementation, including the increased staffing costs and the ongoing need for fixes and updates. The committee questioned whether the VA has properly evaluated the system's cost-effectiveness and its impact on patient care.

The House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations convened a hearing to discuss the VA's continued struggles with the Oracle Cerner EHR system, particularly the pharmacy software. Rep. Rosendale, the Chair of the Subcommittee, highlighted the dangers posed by the system's bugs and workarounds, including increased Pharmacy staffing costs and patient safety risks, citing an alarming increase in patient safety reports related to the pharmacy.

Deputy Inspector General David Case testified that the OIG had discovered significant patient safety concerns related to the new EHR, specifically with medication management. Case noted that errors in the HDR could lead to inaccurate drug-to-drug interaction and allergy checks, potentially affecting at least 250,000 veterans.

The VA announced a program reset in April 2023, halting further deployments of the EHR to focus on improving the existing implementation at five medical centers. The committee expressed concern about the lack of progress made during the reset period and questioned the decision to proceed with the Lovell deployment before the reset goals were achieved.

The hearing centered on the functionality of the Oracle Cerner EHR system and its impact on patient care. The committee expressed concerns about the system's ability to meet the unique demands of VA pharmacy operations, specifically citing the time required to process prescriptions and the ongoing need for manual workarounds. Witnesses from the VA and Oracle acknowledged the challenges but highlighted the ongoing efforts to improve the system.

The committee focused on the issue of inaccurate medication data in the HDR, a problem that has persisted since the initial rollout in Spokane. The OIG highlighted the lack of testing for medication and allergy accuracy, leading to concerns about potential medication errors and patient safety risks. Oracle acknowledged the issue but stated that they have delivered fixes to the HDR database.

The hearing focused on the upcoming deployment of the EHR at the Lovell Federal Health Care Center in North Chicago. The VA expressed confidence in the implementation, citing the joint effort with the DoD and the experience gained from previous deployments. Oracle representatives highlighted the improvements made to the system since the initial rollout at Spokane and expressed optimism about the Lovell deployment.

Throughout the hearing, the committee emphasized the importance of patient safety and the impact of the EHR's shortcomings on veterans. The committee expressed concern about the potential for medication errors and other issues that could harm veterans' health. Witnesses from the VA reiterated their commitment to providing quality care to veterans and addressing the issues related to the EHR system.

Mike Cecil, Executive Vice President for Global Industries at Oracle, countered the concerns by emphasizing the company's commitment to working with the VA to improve the system. He highlighted the recent block 10 upgrade and the upcoming implementation at the Lovell Federal Health Care Center, stating that these deployments would incorporate the most recent enhancements.

The committee expressed serious concern over the VA's failure to notify potentially impacted veterans about the HDR issue. The OIG testified that the VA had recommended notifying veterans but never followed through with the communication plan. The VA witnesses agreed to notify the veterans as soon as possible following the hearing.

The committee raised concerns about the effectiveness of training for staff using the new EHR. Witnesses from the VA discussed the ongoing efforts to improve training and adapt it to the specific needs of providers and pharmacists. The committee emphasized the importance of ensuring that staff are adequately trained to use the system effectively and mitigate potential patient safety risks.

The committee expressed skepticism about the future of the Oracle Cerner EHR system, questioning whether it will ever be able to function effectively and meet the needs of VA patients. The VA witnesses expressed confidence in the system's eventual success, citing the ongoing efforts to improve the software and the upcoming deployment at Lovell. However, the committee remained unconvinced about the long-term viability of the EHR system.

The committee expressed concerns about the significant increase in pharmacy staffing required to manage the new EHR. The VA acknowledged the need for additional staff at the Lovell facility and beyond, stating that they are developing a staffing model to address these requirements.