VA, DoD launch new EHR at joint site — a major milestone for each agency’s rollout

The Department of Veterans Affairs and the Defense Department launched a new, interoperable Electronic Health Record (EHR) on Saturday, at the Capt. James A. Lovell Federal Health Care Center (Lovell FHCC) in North Chicago.

The Lovell Federal Health Care Center is DoD’s final go-live site for the new Oracle-Cerner EHR, which it calls MHS Genesis. DoD has now deployed the new EHR at all its sites across the U.S. and internationally.

The VA, however, has only deployed the Oracle-Cerner EHR at five sites. Full deployment would bring it to more than 170 VA medical centers. The Lovell Center is the VA’s most complex EHR rollout to date.

The VA announced an indefinite freeze on new launches of the Oracle-Cerner EHR in April 2023. The department says the current “reset” period won’t end until it addresses the system’s persistent outages and until VA sites already using the Oracle-Cerner EHR show improved performance.

Neil Evans, acting program executive director of VA’s EHR Modernization Integration Office, told reporters Friday that VA’s ability to resume the EHR rollout will depend, in large part, on the success of the system’s launch at the Lovell FHCC.

“This really has been a part of the reset for us, and frankly, is a part of our path to restarting deployment across the rest of deployment, as we learn from this deployment,” Evans said.

The Lovell Center provides complex medical care to over 75,000 individuals per year. That includes 25,000 veterans every year, over 10,000 TRICARE enrollees and 30,000 Navy recruits.

The facility includes a 300-bed hospital and VA outpatient clinics in the greater Chicago area.

“There’s value in going live at a more complex site, with a higher inpatient volume, a broader set of specialties and the like,” Evans said. “We’re going to learn, based on the more complex facility.”

A combined staff of 3,200 VA and DoD employees provides care to veterans at the facility. Up until this point, FHCC has been operating with both VA and DoD’s legacy EHR systems.

“There have been challenges to operate a single, joint facility with two electronic health records,” Evans said.

Meanwhile, the five VA sites already using the Oracle-Cerner EHR are showing improved performance.

“From a technical performance perspective, we’re in a far, far better spot and doing very well,” he said.

Evans said it’s been 319 days since the Oracle-Cerner EHR saw its last full system outage. He said the VA is also seeing a reduction in incidents that affect individual end-users, such as hangs, crashes and lags.

The Lovell Center was created in October 2010, by merging the former North Chicago VA Medical Center and the former Naval Health Clinic Great Lakes.

The facility provides health care to active-duty military, their family members, military retirees, naval recruits, naval students and veterans in the North Chicago area.

Evans called Saturday’s go-live “the culmination of a long journey” to prepare the Lovell Center for the new EHR.

“We have been making improvements over the course of the reset for our five live sites. But evaluating those, and understanding those, at a more complex site, we think, will be more important,” he said.

VA says it won’t schedule additional VA EHR deployments until officials are confident that the new EHR is highly functioning at all current sites and ready to deliver for Veterans and VA clinicians at future sites.

In preparation for the Lovell Center go-live, Evans said the VA has made  “significant changes” to its EHR training.

“In an electronic health record transition, it’s really about, all in, how do we support end users, in adopting the new solution, and part of that is training, learning how the system works,” he said.

VA employees, he added, have gone through computer-based and instructor-led training, as well as training from “superusers” — “people who have learned forward, and said, ‘I’m excited about helping my peers learn this new system.’”

Evans said the VA has also rolled out “learning labs” to get clinicians ready to use the new EHR.

“They’ve been able to come and see in a sandbox environment and practice themselves in a sandbox environment, the work, the series of steps that they would actually be doing in their regular work,” he said.

Bill Tinston, director of the Federal Electronic Health Record Modernization (FEHRM) office, said DoD personnel have also helped the VA prepare for the Lovell FHCC go-live.

“Bringing that expertise is going to be a great advantage, and it’s one of the advantages to being able to do this jointly. In the end, we do it jointly, so that we get the best outcome for the Americans that we serve here. But for the users, they’ll be in a better position, because they’ll have their peers there, helping them through the process of adopting and getting their jobs done, which is what this is all about,” Tinston said.

Oracle-Cerner has provided several recent pharmacy-related updates to the EHR. Those upgrades are in place at the five VA sites already using the EHR, but Evans said they won’t go into effect at the Lovell Center just yet.

“We made a decision — it was really a clinical decision, based on VA’s pharmacy communities — request that we not go live with the functionality until it is fully and completely fixed 100%,” he said. “We are at a point now where we have done additional training for the pharmacy staff at FHCC, so that they are prepared and understand what work they’ll need to do in the absence of that upgrade … We were at a point where the site is, frankly, as ready as they’re going to be for this kind of transition.”

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