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Spokane, Washington  Est. May 19, 1883

House panel questions VA plan to launch long-stalled computer system in Illinois as pharmacy problems persist

WASHINGTON – A House subcommittee on Thursday questioned the Department of Veterans Affairs’ plan to launch a troubled computer system at a hospital near Chicago, after problems in the Inland Northwest prompted the department to stall the system’s rollout for almost two years.

A representative from the VA’s internal watchdog office, Deputy Inspector General David Case, began his testimony by laying out the findings of a forthcoming report on problems with how the system handles medications, which he said could threaten the safety of 250,000 affected veterans. That will be the office’s 17th report on the electronic health record system since 2020, when Spokane became the test site for the system developed by Oracle Cerner.

“The definition of insanity is doing the same thing over and over again while expecting a different outcome,” said Rep. Matt Rosendale of Montana, the subcommittee’s Republican chairman. “I have come to believe that this continuing effort to transform the Oracle Cerner pharmacy software into something completely different is insanity.”

The central problem identified in the forthcoming report, Case said, is that the new system doesn’t accurately share prescription information with the VA’s existing system, known as VistA, which is still used at all but five of the department’s 171 medical centers. As an example of what can go wrong, he described the case of a veteran who went five days without a critical medication at a residential treatment facility, because the prescription had been entered in the Oracle Cerner system and wasn’t visible in VistA.

Case didn’t disclose where that veteran was treated. After the system launched in October 2020 at Spokane’s Mann-Grandstaff VA Medical Center and its affiliated clinics in Wenatchee, Coeur d’Alene, Sandpoint and Libby, Montana, it was deployed in 2022 at other sites in Eastern Washington and parts of Idaho, Oregon and Ohio.

Rep. Cathy McMorris Rodgers, R-Spokane, is not a member of the committee but joined the hearing to reiterate her belief that the Oracle Cerner system’s rollout – projected to cost more than $33 billion over 13 years – should be canceled.

“At Mann-Grandstaff, pharmacy employees continue to work under extreme pressure, relying on memory to recognize dangerous drug combinations and other problems the system is failing to catch,” McMorris Rodgers said. “We owe it to our nation’s heroes to get this right, and I believe that starts with pulling the plug on this deeply broken system and going back to one that works.”

McMorris Rodgers said she has heard from constituents who went into debt after paying out of pocket for health care they couldn’t get at VA facilities in Eastern Washington, which have been hobbled by the system. She read a statement from an anonymous pharmacist who said, “I cannot do this anymore – the stress of this system, added workload to make it function. I cannot care for my patients and have stopped being able to care for my own well-being.”

Despite the decision to give Cerner a $10 billion sole-source contract under the Trump administration, the only lawmakers to support scrapping the system so far are three Republicans: McMorris Rodgers, Rosendale and Rep. Mike Bost of Illinois, who chairs the full VA Committee.

Democrats, led on the subcommittee by Rep. Sheila Cherfilus-McCormick of Florida, have voiced concerns with the system’s flaws but say they aren’t ready to give up on the project, which is supposed to see the VA adopt a system similar to the one military hospitals have launched in recent years, beginning with Fairchild Air Force Base in 2017.

After applauding the department’s decision to pause the system’s rollout and announce a “reset” in April , Cherfilus-McCormick said she was “extremely concerned” that the VA and Defense Department plan to deploy the system on March 9 at the Lovell Federal Health Care Center in North Chicago, Illinois. When committee staff visited the hospital in December, she said, employees said their concerns about the system had not been addressed.

“It was clear then that the VA providers were not convinced that the software was ready,” Cherfilus-McCormick said. “In fact, Lovell’s pharmacy leadership indicated that they didn’t feel like anything had changed.”

In addition to Case, the witnesses included Oracle executive Mike Sicilia and three VA officials involved in the effort to fix the system, which has been overseen by a rotating cast of leaders. Neil Evans, the acting director of the office charged with the system’s rollout, said the VA and Oracle know there is more work to do.

“As we said before, we’re committed to getting this right,” Evans said, adding that VA leaders still believe transitioning to a system similar to the one used by the Defense Department “will provide significant value.”

After Rosendale asked Evans why the VA hadn’t notified the 250,000 affected patients that their prescription information may have been compromised, Evans committed to doing so.

Rosendale lamented the money the VA has spent on additional staffing to make up for the system’s effects, which limit the number of patients each provider can see. The five hospitals using the system have increased their staffing by 20%, he said, and Evans’ office anticipates that the large, more complex hospital in North Chicago will require as much as 60% more pharmacy staff with the new system.

“And it’s all to prop up a system which is clearly inferior to what the VA has today, which is VistA,” Rosendale said.

Sicilia, who has overseen the contract since Oracle acquired Cerner for $28.3 billion in 2022, reiterated that his company has made progress to fix a system that he admits was flawed when Oracle took over.

Rosendale closed the hearing with a line directed to Sicilia, an apparent reference to Oracle’s lobbying efforts.

“We’re $9 billion and five years into this system, and we still don’t have a functioning system,” Rosendale said.

“I wish that you invested as much time, effort and money into getting that system straight as you have trying to buy votes on Capitol Hill.”