Vet agency asks why fix outdated-but-outgoing record system?

Veterans Affairs leaders have called their soon-to-be-replaced electronic health outdated and expensive to maintain. But Republican lawmakers insisted on Tuesday that VA must keep that system running for the foreseeable future, thanks to all the glitches rolling out the new replacement software.

“Regardless of how we feel about it, VA will probably continue to rely on VistA for at least another decade,” said Rep. Matt Rosendale, R-Mont., head of the House Veterans’ Affairs Committee’s technology panel.

VistA — the Veterans Health Information Systems and Technology Architecture — is the decades-old medical software used throughout department medical sites for a host of record keeping, medication tracking and appointment scheduling tasks. It’s slated to be replaced by 2028, but Rosendale questioned whether a planned replacement software system can do everything the old one does, and said he expects some medical centers and veterans to rely on parts of VistA for years to come.

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Replacing the system has been the goal of federal officials and some politicians for years, with an eye towards putting veterans’ health records and Defense Department medical files on the same platform for the first time.

But the latest attempt at that — a 10-year, $16-billion effort to install Oracle Cerner’s Millennium records system at VA sites — has faced repeated delays over concerns about staff training and patient safety. VA officials postponed all new deployments of the system last fall but are scheduled to resume work later this summer.

Since then, multiple lawmakers (including Rosendale) have questioned whether the transition can ever be a success, and whether keeping VistA should be reconsidered. Tuesday’s hearing was the first in a series of hearings planned on the issue, as Congress prepares its draft plans for the fiscal 2024 budget.

In response to questions about VistA’s viability, VA officials described VistA as “relatively stable” and noted generally positive views of the software among current VA staff.

But Daniel McCune, VA’s executive director of software product management, said maintaining the current system presents multiple challenges, most notably price (it cost about $900 million last year) and staff upkeep issues.

“VistA is written in an old programming language, Mumps,” he told lawmakers. “There are few Mumps programmers today, because Mumps is not taught in computer science classes anymore. The pool of Mumps programmers shrinks every year as they retire.”

Other shortcomings, such as disparate versions of the software which struggle to sync with each other, make a new, upgraded system more desirable, McCune said. VA officials are still hopeful that their own health records project can be completed by 2028, despite recent delays and setbacks.

Earlier in the day, officials from the Defense Department’s health care system testified across Capitol Hill about the ongoing, relatively trouble-free deployment of their Oracle Cerner records software, saying the work is about 75% complete and that staff are working with VA liaisons to prepare for both departments eventually sharing the same system framework. The military’s software deployment has not been beset by the same level of turmoil as the VA rollout.

Last month, in response to criticism over the Millennium software deployment, officials from Oracle Cerner promised improvements in their work but also argued that “there is not enough time or money to ever make VistA work like a modern system.”

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Democratic lawmakers echoed that sentiment at Tuesday’s hearing.

“If VA is admitting it does not want and does not have the capacity to manage a VistA modernization, why would Congress force them to?” said Rep. Sheila Cherfilus-McCormick, D-Fla.

But Republican lawmakers said because of ongoing problems with the Millennium software glitches and training mistakes, the idea needs to be discussed.

They criticized VA officials for not having current estimates on what a fully rebuilt VistA might cost, and for trusting too much in Oracle Cerner’s ability to get the project back on track.

Several former VA officials invited as witnesses by GOP committee members backed the idea of investing and upgrading VistA, saying they also have lost faith in the promised modernization project.

Officials from Oracle Cerner were not invited to testify at Tuesday’s hearing but are expected to be summoned before lawmakers for additional questioning in coming weeks.