Leadership Gaps at VA Could Impact Cerner EHR Rollout

Lawmakers expressed their frustrations with the lack of crucial leadership at the Department of Veterans Affairs (VA) as the agency prepares for implementation of a new, $16 billion electronic health records (EHR) system.

The VA is preparing to undergo a $16 billion overhaul of its EHR system after finalizing a contract with the health information systems company Cerner. Additionally, a recent report from the Government Accounting Office (GAO) found that the agency has spent $1 billion on EHR systems per year for the last 3 years. 

While this finding puts the VA’s projected $16 billion spending on EHR over the next 10 years at a higher cost compared to current spending, Phil Roe, MD, (R-Tennessee), of the House of Representatives, said that this price tag includes many improvements to the current system—which could cut costs in other areas.

“$15.8 billion dollars over to 10 years, including $10 billion to Cerner, is a staggering number for an enormous government agency,” Rep Roe said during a Committee on Veterans Affairs hearing. “However, EHR software is only a relatively small part of the overall price tag. What exactly does all that money buy? The EHR Modernization is not just a technology project; it will have a major impact on the way VA operates. That means clinical and administrative workflows. It will also reshape the culture.”

The VA has set the launch date for the implementation of Cerner’s new EHR system for March 2020, according to Peter O’Rourke, acting secretary of the VA.

However, lawmakers expressed frustrations with the lack of qualified leadership in place to oversee the implementation of the new system in recent months. After Secretary David Shulkin, MD, was fired in April, a number of other VA officials left the agency. 

Currently, the deputy secretary, the undersecretary for health, and the chief information officer (CIO) are currently vacant at the VA. In early June, Thomas Bowman retired as deputy secretary, while Scott Blackburn, acting CIO, resigned after the ouster of Dr Shulkin. Meanwhile, the position of undersecretary for health has remained vacant for 16 months.

The former director of data operations for the Trump Campaign, Camilo Sandoval, has temporarily replaced Mr Blackburn. However, Mr Sandoval was not invited to the recent hearing on Cerner implementation at the Committee on Veterans Affairs.

“I don’t see how this is going to end well if we don’t get the top leadership positions in place… especially the chief information officer, as a highly qualified individual to oversee this project,” Mark Takano (D-California), said during the hearing. “It’s not on you. It’s on the White House for leaving these positions unfilled especially when we have this massive, massive contract.”

Julia Brownley (D-California) added that she is worried based on her experience with leadership issues at the VA causing problems in the past.

“Lack of leadership or turnover in leadership has caused delays in almost any endeavor that has been undertaken,” she said. “I share the concerns of many in the committee that at the outset we’re worried about various deadlines and meeting the interim goals as we move forward on this.”

—David Costil