Technology Modernization Chairman Rosendale Delivers Opening Remarks at 2nd Oversight Hearing on Electronic Health Record Modernization

Press Release

"Good afternoon.

The Subcommittee will come to order.

A great deal has changed since our last hearing.

VA has finally acknowledged that the Oracle Cerner electronic health record system is not fully functional and not suitable to deploy to any other facility.

After nearly three years of pressing forward despite the mounting consequences to veterans' safety, staff burnout, and billions of dollars wasted, Secretary McDonough and Dr. Evans have become realistic about the future of this ill-conceived project.

That is encouraging.

But it has been painful to watch this disaster unfold.

It has been frustrating to argue and plead with VA not to march off a cliff with the Oracle Cerner EHR, only to be ignored or stonewalled.

Thankfully, the Department is now listening to what veterans, its own employees, and this Committee have been saying for so long.

Now is the time to look under the hood of the EHR and see if it can be fixed and whether progress is being made.

We are here today to take an in-depth look at one particularly dysfunctional aspect of the EHR--pharmacy.

Pharmacy is crucial to veterans' health and wellbeing, and unfortunately it is one of the most error-ridden and dangerous parts of the system.

First and foremost, we need to listen to the VA pharmacists who use it every day.

To that end, the Subcommittee sent questionnaires to each of the five medical centers using Oracle Cerner. We received responses from Spokane, Walla Walla, Columbus, and Roseburg.

The situation they describe is outrageous.

The pharmacists cannot trust the system, so they have to work in a constant state of hypervigilance.

The Spokane medical center has been live on the Oracle Cerner EHR for two-and-a-half years, yet they continue to discover new problems every week.

Across these sites, patient safety reports are up over 300 percent since the EHR went live, and about a quarter of these incidents are directly related to pharmacy.

The medical centers have added on average 20 percent more pharmacy employees to perform the same workload, on top of relying on support from remote pharmacists.

Columbus even had to dedicate a pharmacist to manage the Cerner help desk tickets full-time, and they created a management position in the pharmacy just to deal with the EHR.

Altogether, the pharmacy operations at Spokane, Walla Walla, and Columbus have seen a more than $9 million deficit from increased staffing costs and lost copays and collections.

On average, the staff's struggles with the EHR have shaved about 22 points off these medical centers' scores in the best places to work survey.

The pharmacists are in distress, and they do not feel their concerns are being taken seriously.

That is deeply unfortunate, because they--not the VA central office, not Cerner--have been doing the crucial work to document the system's flaws since the very beginning.

It was the Spokane pharmacists who wrote the initial 57-page patient safety domain report in August 2021.

It was the pharmacists at these medical centers who identified the 79 business requirement change requests and continue to track them.

Some of their findings went into the improvement sprint report that Dr. Evans' office released in March, but it appears that much more was excluded.

Oracle Cerner released pharmacy updates in February and late April, and another one is slated for August.

The pharmacists believe some of these updates have been successful and produced incremental improvements.

As for the more significant updates, they seem to have created as many new complications as they resolved.

And VA and Oracle Cerner are barely scratching the surface, tackling only a handful high-priority issues from a list that is approaching 100.

I appreciate all our witnesses joining us today so we can dig into these pharmacy updates and the trajectory for improvement.

We expect the VA pharmacists to give our veterans world-class service, and we owe them fully functional technology to do that.

'With that, I yield to Ranking Member Cherfilus-McCormick for her opening statement."

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