VA’s Ongoing Struggle with Oracle Health EHR Performance Despite Improvements

November 22, 2023

The Department of Veterans Affairs (VA) has seen some improvements in the performance of its Oracle Health Electronic Health Record (EHR) system, yet challenges persist, with frontline healthcare workers still encountering disruptions in the system.

Federal News Network reported that although the VA’s Oracle Health EHR has not experienced a complete outage in over six months, end-users have continued to encounter issues with the system’s functionality.

As of November 8, the new platform achieved 185 consecutive days without a total outage and maintained 100 percent system availability during 10 of the last 12 months. However, it fell short of meeting the metric outlined in the VA contract, aiming for incident-free operation 95 percent of the time, achieving this standard in only four of the past ten months by September 30.

Kurt DelBene, VA CIO and assistant secretary for information and technology addressed the House VA Committee during a technology modernization subcommittee hearing, acknowledging persistent partial system failures that impact users despite the progress made.

With an investment of nearly $4 billion, the VA has implemented the new system in only five medical centers, significantly below the intended deployment scope of over 170 VA medical facilities. Following problems at existing sites, the VA halted further EHR deployments in April.

Subcommittee Chairman Matt Rosendale highlighted a reduction in nationwide outages but emphasized the prevalence of crashes, hang-ups, and errors affecting specific facilities or users. He referenced data from KLAS Research indicating dissatisfaction among frontline employees, with only a minority agreeing that the EHR met their needs without downtime and enabling high-quality care delivery.

Rosendale raised concerns about EHR-related incidents that potentially contributed to close calls or patient harm, emphasizing a discrepancy between VA and Oracle’s criteria for system performance and the reality faced by end-users.

Sheila Cherfilus-McCormick, the subcommittee ranking member, echoed concerns regarding the mismatch between reported data and feedback from frontline staff, citing frequent complaints about system slowness or non-functionality.

DelBene attributed the recurring partial system failures to the high rate of changes being implemented, emphasizing that systems stabilize as the rate of change decreases. He highlighted instances where the VA requested functionalities not commercially deployed by Oracle Health, contributing to increased incident risk.

Acknowledging the need for stability, DelBene anticipated system performance improvement as change velocity decreases and unforeseen defects are addressed over time. He mentioned that the average user experiences about two brief system pauses lasting five seconds or less on any given day.

While expressing optimism about the EHR’s future rollout, DelBene emphasized the importance of ensuring a quality user experience before resuming deployments. He stressed ongoing concerns and significant issues that the VA is collaborating with Oracle on, signaling that the system is not yet fully prepared for widespread implementation.

The VA’s plans to recommence EHR implementations are contingent on the success of the platform’s launch in March 2024 at the Capt. James A. Lovell Federal Health Care Center in Chicago.

Overall, despite improvements, the VA’s Oracle Health EHR struggles persistently. End-users face ongoing disruptions, casting doubt on the system’s reliability for quality patient care. Limited deployment and halting further implementations underscore existing challenges. High rates of system changes hinder stability, necessitating a cautious approach to future rollouts. While optimism exists for improvements, ensuring a quality user experience remains pivotal. The VA’s plans for recommencing EHR implementations hinge upon addressing concerns and achieving substantial enhancements, emphasizing the importance of stability and reliability in healthcare systems.


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