A leader with the Veterans Affairs Department on Wednesday confirmed to lawmakers that the agency is on track to bring its first site live on a new $16 billion electronic health record system next month, saying the system is 99% ready.
That first site—Mann-Grandstaff VA Medical Center in Spokane, Wash.—is scheduled to go live on the new Cerner Corp. EHR system on Oct. 24.
Since delaying the rollout —then scheduled for July—in April on account of COVID-19, the VA has completed testing for all 73 of the interfaces needed for the first phase of Mann-Grandstaff VA's EHR implementation, said John Windom, executive director for the VA's Office of EHR Modernization, during a hearing with the House Veterans' Affairs Committee's Technology Modernization Subcommittee. In April, VA officials had said it had 72 of the 73 interfaces ready for testing.
The VA plans for sites to go live on the new EHR in two phases. The second—and final—capability set is expected to be ready in spring 2021.
The COVID-19 delay, announced in April, came on the heels of the VA's decision in February to push back Mann-Grandstaff VA's go-live from March to July, needing more time to build the system.
Windom on Wednesday said that although the 73 interfaces are complete, he will continue to say the work is 99% ready. "We're training up until the last moment; we're testing up until the last moment," Windom said. "The solidification of workflows is an ongoing process. You think you're at 100%, and you're still tweaking, if you will."
"I will never report to you that workflows are 100% complete," he added.
Mann-Grandstaff VA is in its sixth week of end-user training, said Dr. Laura Kroupa, chief medical officer for the VA's Office of EHR Modernization.
Since the winter, the VA also rearranged its 10-year schedule for bringing sites live on the EHR system to initially focus on rolling out to small and mid-sized centers in the Northwest and Midwest.
The "VA's road to initial operating capability in Spokane, Washington, has been a long and winding road, to put it mildly," said Rep. Jim Banks (R-Ind.). "I am now confident that about one month from now the Mann-Grandstaff VA Medical Center will be using the Cerner Millennium EHR."
But Banks and Rep. Susie Lee (D-Nev.), chair for the Technology Modernization subcommittee, questioned the VA's plans for its patient portal.
The VA's current patient portal is called My HealtheVet; however, the VA also plans to implement a patient portal from Cerner on an interim basis, which would be used by patients at facilities that go live on the Cerner EHR.
The VA hasn't determined whether it will continue to use My HealtheVet or Cerner's patient portal in the long-term, according to Windom. He cited an estimate that it would cost between $60 million to $300 million to modify and integrate My HealtheVet with the Cerner EHR.
"That's an ongoing discussion," Windom said. "There's no decision about the evolution of HealtheVet that's documented yet."
The VA in 2018 inked a $10 billion contract with Cerner for a 10-year rollout of an EHR system, which replaces the agency's homegrown EHR, VistA.
Since then, costs for the project have continued to climb. The VA has estimated it will need another $6.1 billion for costs related to program management and infrastructure, as well as additional funding to cover other physical upgrades needed for individual healthcare facilities, according to an April report from the VA Office of Inspector General.
