For decades, the Department of Veterans Affairs (VA) has been working to establish and improve its digitization practices, specifically as they relate to the Electronic Health Record (EHR) system. Originally designed to transfer the paper records of veterans to an online, digital format, the EHR has had a lengthy history of both improvements and setbacks. For anyone who works in information technology (IT) and/or healthcare with technology vendors, it’s an important program to understand. Let’s take a quick look back at all you need to know to be up to date on VA’s EHR.
A Snapshot of EHR’s History
The first steps toward establishing an EHR began initially in the 1980s, with the onset of an internal version of the electronic health record. By the 1990s, the name of the internal system had been changed to the Veterans Health Information Systems and Technology Architecture (VistA). It became the first VA-wide image management system, allowing physicians immediate access to patient medical images, regardless of location.
Fast forward to the early 2000s, and the VA began to modernize the original architecture by eliminating the 130 different versions of VistA, eventually leading to the joint DoD/VA electronic health record, or iEHR. Unfortunately, iEHR was relatively short-lived, as costs piled up and deadlines slipped. From there, a subsequent third revolution of the program branded as “VistA Evolution” was created, and originally intended to be completed by 2018 at a cost of roughly $4 billion through 2028.
Cerner Corporation was awarded a contract by the DoD in 2015 for just over $3 billion to roll out the newest version of the system. By 2017, the VA acquired the same Cerner system as the Department of Defense (DoD), and together in 2018, the DoD and VA created an interoperable edition of the EHR.
This is where our story takes a bit of a turn, adding a series of more modern hiccups to EHR’s deployment.
2020 to Today
In 2020, just prior to the start COVID-19 pandemic, the VA deployed the latest EHR system to the Mann-Granstaff VA Medical Center in Spokane, Washington. This was the only deployment in FY21. FY22 brought four additional medical centers in Washington, Ohio and Oregon.
This brings us to Q3FY23, and the latest developments. All additional deployments have since been halted, citing the need to correct several errors. Challenges began to surface at the centers equipped with the newest system. According to the EHR Modernization Sprint Report, which catalogued issues following each of the deployments:
“Throughout this EHR Modernization (EHRM) program, we as an organization have learned a lot. In 2022, it became more and more evident that our structure and our processes were not optimal for successful deployments or to fix issues identified after deployments. Furthermore, it was evident that there was still much work to be done to standardize processes across VA and to continually optimize the new record for use in VA.”
As of July 2023, the system has not yet been launched at any additional sites. It’s likely we may see movement on the effort shortly though, as the last estimate from the VA was to resume in June of 2023.
Consider yourself caught up to the highlights of EHR. If history has shown us anything though, stay tuned because this story is certainly to be continued.
Susanna Patten is a senior analyst on the TD SYNNEX Public Sector Market Insights team covering technology domain centric trends across the public sector.
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