VA's decision to keep troubled computer system in Spokane amid halt elsewhere met with mix of praise, anger

Apr. 22—WASHINGTON — Friday's decision by the Department of Veterans Affairs to stop the deployment of a flawed computer system while continuing to use it in the Inland Northwest was met with a mix of praise from Congress and frustration from the system's critics.

On Friday morning, the VA announced it would halt all future launches of the electronic health record system it began using in Spokane in 2020, the beginning of what was then supposed to be a 10-year, roughly $16 billion project to replace the existing system used at the nation's nearly 1,300 VA clinics and hospitals with one developed by Cerner Corp., which was acquired by the tech giant Oracle in June 2022 and is now known as Oracle Cerner.

In the two-and-a-half years since the system arrived at Spokane's Mann-Grandstaff VA Medical Center, it has frequently crashed, driven exhausted employees to quit and caused medication errors and dangerous delays in treatment. Despite those problems — and acknowledging the system is not "ready to deliver for veterans" elsewhere — VA leaders said it would remain in use in Spokane and four other sites: Walla Walla, Roseburg and White City, Oregon, and Columbus, Ohio.

"We've heard from Veterans and VA clinicians that the new electronic health record is not meeting expectations — and we're holding Oracle Cerner and ourselves accountable to get this right," VA Secretary Denis McDonough said in a statement. "This reset period will allow us to 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."

Members of Congress from both parties welcomed that decision in statements on Friday, a day after Democrats and Republicans in the House sponsored a bill — already introduced by Senate Democrats — aimed at fixing the troubled program. That legislation is backed by Sen. Patty Murray, D-Wash., and Rep. Cathy McMorris Rodgers, R-Spokane, among others.

"I hope this reset means real results," Murray said in a statement, "but in the meantime, I'll continue working with my colleagues to pass legislation that implements the kind of aggressive oversight needed to fix the current EHR system while also making clear that the contract negotiation process should put in place the types of incentives and penalties to ensure these kinds of failures never occur again."

The VA is renegotiating the $10 billion contract it gave Cerner in 2018 without a competitive bidding process. In a call with reporters on Thursday, Neil Evans, the interim director of the new system's rollout, declined to give any details on the ongoing contract talks.

In a statement, McMorris Rodgers said she was glad to see the VA "finally taking ownership" of the system's "failed rollout" in Eastern Washington, North Idaho and parts of Oregon, Montana and Ohio.

"Accountability is the first step down the long road towards getting this right," she said. "Veterans in Eastern Washington deserve a system that works for them, so while I believe the decision to halt the rollout is the right one, my oversight of the system will continue so no more veterans are hurt by it."

Charlie Bourg is an Army veteran from Chewelah who was diagnosed with terminal cancer after problems with the Oracle Cerner system caused a roughly yearlong delay in his diagnosis and treatment. In an interview, Bourg said Friday's announcement suggested that his efforts to raise the alarm about the system's flaws — including meetings in D.C. with lawmakers and veterans' service organizations in December — were largely ignored.

"It shows a real lack of empathy or care about the veterans and their families," he said. "We made it very clear we're tired of being guinea pigs."

Ed Meagher, a vocal critic of the Oracle Cerner system who served as a top VA technology official between 2001 and 2006, said the VA's announcement didn't go far enough. Like Bourg, he wants the five affected hospitals to revert to the VA's existing system, called VistA, that is still used at other medical centers.

"I believe the continued experimentation on veterans and clinicians at the five sites is immoral," Meagher said. "It's unethical. It's just not how you do things in the IT world, especially a mission-critical, life-and-death system."

A report by the VA Office of Inspector General in July 2022 revealed that the system had caused nearly 150 cases of harm to Inland Northwest veterans, mainly due to delayed care. In October, the department notified more than 71,000 veterans that the system may have impacted their health care, and in March VA officials told Congress the system had played a role in the deaths of four veterans.

Meagher said problems with the new system should be worked out in a test environment, not with the roughly 200,000 veterans who rely on the hospitals and clinics where it is now in use. He estimated that switching back to VistA would take only a matter of weeks, but Evans, the VA official leading the project, told reporters Thursday that doing so would be "really, really difficult."

Roger Baker, the VA's chief information officer from 2009 to 2013, said that while there are "plausible technical reasons" why the department wouldn't revert to VistA at the five affected sites, he suspects the main reason VA leaders have opted to keep the Oracle Cerner system there is that by admitting failure, they would lose the funding Congress appropriates for adopting the new system, about $1.6 billion in the current fiscal year.

In a press release announcing the halt, the VA said the decision would reduce the cost of activities related to the new system by about $400 million. In the best-case scenario, Baker said, the department would use much of the remaining money to ensure veterans get better care at the affected facilities.

"If they do this right, they will swarm those five sites, and they'll put real effort into making things right for those five sites to the point where they actually have medical outcomes equivalent to what they're getting at the VistA facilities," he said. "And if they get to that point, then they can talk about moving forward again."

In an email to staff in the Northwest, VA regional director Teresa Boyd thanked the employees who have been struggling with the new system for their "perseverance, patience, and can-do attitudes that have allowed us to get to this point."

"As we look to the next days and months, now more than ever I am counting on you to be 'all in' as VA works on improvements that are so very much needed," Boyd wrote.

Orion Donovan-Smith's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.