A Republican-led discussion draft of legislation to enhance oversight of the Department of Veterans Affairs’ beleaguered electronic health record modernization program proposes to revive many of the same measures stripped from a comprehensive veterans’ bill that was signed into law earlier this year.
VA initially signed a $10 billion contract — which was later revised to over $16 billion — with Cerner in May 2018 to modernize its legacy health record system and make it interoperable with the Pentagon’s new health record, which was also provided by Cerner. Oracle later acquired Cerner in 2022.
Issues with the new EHR system arose almost as soon as it was first deployed in 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington. Those included a series of patient safety concerns, technical glitches and usability challenges that ultimately led to VA pausing most rollouts of the software at additional medical facilities in April 2023. As of this month, the new EHR system has been implemented at just six of VA’s 170 medical centers.
VA announced in December, however, that it would be moving out of its operational pause and was looking to deploy the new software at four Michigan-based medical sites in mid-2026. VA Secretary Doug Collins subsequently announced in March that the agency was planning to deploy the new EHR system at nine additional medical facilities next year, bringing the total to 13 sites.
The new discussion draft was one of nine legislative proposals reviewed during a House Veterans’ Affairs Oversight and Investigations Subcommittee hearing on Wednesday and received tentative support from VA and a prominent veteran service organization.
Cherri Waters — VA’s acting deputy chief information officer and the executive director of the agency’s health portfolio — said the agency “supports the intent of modernizing VA’s electronic health record system, subject to amendments and the availability of appropriations,” although she added that VA planned to work with the committee to address some of the technical concerns it had about specific sections of the discussion draft.
Cole Lyle, director of the Veterans Affairs and rehabilitation division at the American Legion, also said the organization backed the draft measure.
“Many of this bill’s provisions, including the establishment of a baseline for standardized clinical workflows, developing clearly defined leadership roles and securing personal data will go a long way towards program sustainability and successful deployment at future sites,” Lyle said.
The EHRM proposal discussed during Wednesday’s hearing included most of the exact same EHR-related provisions that were removed from the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act before it passed Congress and was signed into law in January by former President Joe Biden.
The Dole Act was first introduced by Rep. Juan Ciscomani, R-Ariz., in May 2024 and received the backing of Democrats and Republicans overseeing the House and Senate VA panels.
The version initially introduced by Ciscomani included, in part, new requirements for the agency to report to Congress about the EHRM program and a streamlined internal VA management structure to oversee the modernization project, as well as stricter protections around veterans’ personal data and health information.
These sections were ultimately stripped from the measure before it passed the House last November. A spokesperson for the House Veterans’ Affairs Committee told Nextgov/FCW at the time that the proposals were removed from the package during bipartisan negotiations “due to a lack of political viability in both the House and Senate.” They added, however, that it remained a high-priority issue for the panel.
The sections removed from the Dole Act were, in turn, taken from many of the provisions found in the EHR Program RESET Act, which was introduced in March 2023 by former Sen. Jon Tester, D-Mont., the then-chairman of the Senate Veterans’ Affairs Committee. That bill was subsequently introduced by the leaders of the House Veterans’ Affairs Committee the following month.
A comparison of the new discussion draft with the original version of the Dole Act shows almost verbatim language when it comes to reporting requirements for the EHRM program.
This includes the same proposal to establish “standard health care quality metrics for purposes of evaluating the provision of health care during the implementation and adoption of the electronic health record system.”
The discussion draft — as well as the stripped Dole Act language — would also expand VA’s mandated disclosure requirements by directing the agency to expand its quarterly reports about the EHRM project to Congress by adding, in part, data “on user adoption and employee satisfaction” with the new system and “data on employee retention and turnover at medical facilities where such electronic health record system is in use.”
Both measures also clearly define the agency’s internal governance structure for the modernization effort, which includes responsibilities and duties for the deputy VA secretary, under secretary for health and assistant secretary for information and technology.
The new discussion draft, notably, does not include language from the initially introduced Dole Act that would also apply to “other health information technology activities and systems of the Department.”
