VA advances Electronic Health Record Modernization program

Updated deployment schedule, management structure and governance

WASHINGTON — The Department of Veterans Affairs announced today its updated plan to move forward with its systemwide Electronic Health Record Modernization program.

The plan will mitigate challenges documented in the Comprehensive Lessons Learned report submitted to Congress after this year’s strategic review of the EHRM program.

“We will do everything we can to get electronic health records right for Veterans and our health care staff, with patient safety being the key driver and nonnegotiable,” said VA Deputy Secretary Donald M. Remy. “I have incorporated the lessons learned I received during my recent meetings with our team at Mann-Grandstaff VA Medical Center in Spokane, Washington, into this new way forward. Under my direction, VA is refining EHR governance and management structures to establish additional rigor and oversight. VA, in coordination with our partners, the Department of Defense and EHR vendor Cerner, will continue to update and refine the EHR implementation process to ensure it delivers the excellence Veterans expect and deserve from VA.”

VA has developed a revised schedule for how it will roll out the EHR system across the department to early fiscal year 2024. VA leveraged lessons learned at our initial operating capability sites and incorporated feedback from facility end users, Veterans Integrated Support Network leadership, and Veterans Health Administration program offices. Pre-deployment activities are underway in VISNs 10 and 20 while preparing for future fiscal year site deployments in VISNs 12 and 23. VISN 12 includes the joint VA-DOD site in North Chicago, where coordination activities have begun. Future deployments, adjustments, and/or modifications to the schedule will be made based on any additional clinical and technical findings and will continuously consider the effects of the ongoing COVID-19 pandemic.

The new EHR management structure will be streamlined and supported by a revised program and change management approach that incorporates best practices in communication, risk management, business process, system development lifecycle management, and customer experience. Among the critical changes in the management of the EHR program is the establishment of:

• A Program Executive Director (PED) for EHR Integration.
• A significantly strengthened Office of the Functional Champion (OFC).
• A Deputy Chief Information Officer (DCIO) for EHR.

The PED, a new position, will report directly to the VA Deputy Secretary and be responsible for cross organizational and cross functional coordination of communication and implementation strategies, to include functional, technical and program management. The PED will have operational control over the offices of Functional Champion, Technical Integration and Program Management, all dedicated to the success of the EHR effort.

The VA Secretary has selected Terry Adirim, M.D., M.P.H., M.B.A., to be the PED. Dr. Adirim is the Principal Deputy Assistant Secretary of Defense and is currently serving as the Acting Assistant Secretary of Defense for Health Affairs.

The strengthened OFC is a significant structural change for this new approach and will significantly increase VHA’s engagement and expand the functional champion role and its associated team. OFC will ensure appropriate clinical involvement that will include having a principal role in processing and resolving patient safety concerns. Additionally, OFC will help bridge any divides among IT, the EHR vendor and the care delivery teams to ensure the needs of the practicing clinicians and support staff are met.

The DCIO, a new position, will assume all technology integration functions for the program and ensure close bidirectional communication with technical staff at local sites.

The strategic review also identified a need for greater clarity of responsibilities and empowerment of a governance structure that was better able to receive stakeholder input and ensure timely decision making. As a result, VA has prioritized resolving these issues and is establishing a new EHR Integration Council. The council, chaired by the PED, will ensure decisions are fully coordinated and timely while addressing the need for an operational decision layer at the enterprise level.

For more information about the EHRM effort, see VA’s Electronic Health Record Comprehensive Lessons Learned update.