Promoting Partnerships To Improve Veterans’ Health

On February 15, 2024, the Subcommittee on Technology Modernization conducted an Oversight Hearing titled “Electronic Health Record Modernization Deep Dive: Can the Oracle Pharmacy Software Be Made Safe and Effective?” The hearing shed light on significant challenges faced by the Department of Veterans Affairs (VA) in implementing the Oracle Electronic Health Record (EHR) system. The issues discussed included increased Pharmacy Staffing needs, errors in medication information, and concerns regarding patient safety:

• David Case, Deputy Inspector General for VA's OIG, informed lawmakers that an upcoming report revealed potential risks in the VA's pharmacy software. Patients at both new and legacy EHR sites may be prescribed contraindicated medications, and legacy providers may make clinical decisions based on inaccurate data. Approximately 250,000 veterans with medication orders or allergies documented in the new EHR as of September 2023 are at risk if they visit legacy EHR sites.
• The primary issue highlighted in the upcoming report, as stated by David Case, is the inaccurate sharing of prescription information between the new Oracle EHR system and the VA's existing VistA system. This discrepancy poses a critical challenge as VistA is still in use at all but five of the VA's 171 medical centers.
  
• Neil Evans, acting program executive director of VA’s Office of Electronic Health Records Modernization, expressed the department's commitment to achieving success in transitioning to a "single-instance, enterprise-wide electronic health record" interoperable with DOD's new EHR system. Despite challenges, he highlighted the joint deployment with DOD at the Captain James A. Lovell Federal Health Care Center scheduled for early March. This deployment is significant as it marks the final federal EHR deployment at a DOD site and the first VA deployment at a larger and more complex VA health care facility.
• The Oracle EHR system's adoption has led to a surge in Pharmacy Staffing needs within the VA. The five hospitals using the system have increased their staffing by 20%, 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.