Oracle executive pushes back on bills that could ‘kill’ company’s VA health record system

WASHINGTON – The company behind a new Department of Veterans Affairs computer system that has harmed Inland Northwest patients since Spokane became its testing ground in 2020 is pushing back after House Republicans introduced two bills that would either freeze the system’s further rollout or scrap it altogether.

In two recent blog posts and an interview with The Spokesman-Review, Ken Glueck, an executive vice president and top lobbyist at Oracle Corp., touted the progress the tech giant has made since it acquired Cerner in June 2022, four years after the smaller company – now known as Oracle Cerner – signed a $10 billion contract to replace the VA’s existing electronic health record system.

“Why this is so exciting is that in June 2022, the government essentially got two vendors for the price of one,” he said in the interview. “They got a real engineering company and a real clinical company.”

In an annual report delivered to Congress, Oracle said it had improved the system’s performance, with “the most severe type of outages” down 67%. The company also delivered high-priority fixes to the system’s pharmacy module and other issues and engaged the consulting firm Accenture to improve training on the system.

While acknowledging problems that have slowed health care workers and threatened patient safety, Glueck said his company is working with the VA to quickly resolve them and argued that canceling the project would waste an opportunity for the VA to be the first beneficiary of a web-based version of the system Oracle is building. The company has promised to deliver a test version of that new system to the VA by the end of 2023. Oracle is not required to create a web-based system for the VA under its contract.

“The federal government is getting the benefit for work that we’re going to do anyway for our commercial clients,” Glueck said. “This is just an additional option. It’s like a Happy Meal – you get something new for free, and that’s exciting, but it’s only if they want.”

On Jan. 31, the GOP leaders of the House VA Committee introduced two bills aimed at stopping the system’s planned launch at four hospitals in Michigan this summer. One, backed only by Reps. Mike Bost of Illinois and Matt Rosendale of Montana, the chairmen of the full panel and a subcommittee, would terminate the program.

The other – cosponsored by 10 lawmakers, including Reps. Cathy McMorris Rodgers of Spokane and Dan Newhouse of Sunnyside – would stop the rollout until national and local VA leaders at each hospital decide the system is ready to launch safely. While that “improvement” bill may appear to be a middle ground, Glueck said, it would be even worse than scrapping the system immediately.

“The reality is that I think the termination act kills this quickly and the improvement act kills it slowly,” he said, arguing that devolving go-ahead authority to the leaders of the VA’s 171 medical centers would lead to an unmanageable patchwork of hospitals using different computer systems.

Democrats on the House and Senate VA panels have signaled they won’t support either bill, arguing that provisions in the annual spending bill Congress passed in December will do enough to hold the VA and Oracle Cerner accountable. Glueck pointed out that Oracle has been in charge of the project for barely half a year and said it will complete improvements to the system before its next scheduled launch in June in Saginaw, Michigan.

“Give us some appropriate amount of time to either sink or swim,” Glueck said, adding that the House panel had committed to doing just that before the Republicans unveiled their bills. “If this thing is not salvageable, that’s a decision which probably should be made this time next year.”

Rep. Mark Takano, the top Democrat on the House VA Committee, said in a statement he has been “adamant that patient safety concerns be adequately addressed before any further ‘go lives’ across the VA enterprise.”

“I am not opposed to changes to the program, and I am committed to working in a bipartisan and bicameral manner to make such changes,” the California Democrat said, adding that he doesn’t agree with canceling the project “without a viable solution to replace it.”

Sen. Jon Tester of Montana, the Democratic chairman of the Senate VA Committee, said he is holding the VA and Oracle Cerner accountable for making the system safe.

“The men and women who risk their lives to defend our country deserve to get the care they have earned when they return home,” Tester said in a statement. “Make no mistake, modernization of the electronic health record is not optional – one way or another it has to be done. And I will keep demanding results on behalf of every veteran and dedicated VA medical professional until we get this right.”

After FedScoop reported Feb. 2 that Democrats on the panel were working on their own proposal, GOP committee spokeswoman Kathleen McCarthy responded in a statement, “Chairman Bost is open to any idea that holds VA and Oracle Cerner accountable, but the time for half-measures and tinkering around the edges is over.”

As the system’s problems have come to light through congressional testimony, federal watchdog reports and reporting in The Spokesman-Review and other outlets, Democrats and Republicans have increasingly jostled to appear tough on an issue that has been largely nonpartisan. While then-President Donald Trump’s son-in-law Jared Kushner played a key role in giving Cerner the $10 billion contract and skipping a competitive bidding process, the Biden administration has opted to continue the project.

Under VA Secretary Denis McDonough, the project has seen multiple delays and changes of leadership. Terry Adirim, the VA executive in charge of the Oracle Cerner rollout since December 2021, will leave the role Feb. 25, according to an internal VA email.

A spokesman for Sen. Patty Murray, who sits on the VA Committee and controls the program’s funding as chair of the Appropriations Committee, said the Washington Democrat “has been as aggressive as any member, in the Senate or the House,” when it comes to oversight of the project.

“Senator Murray is reviewing the Republican legislation, and is also working with her colleagues on their next legislative and oversight options to hold VA and Oracle Cerner accountable to our veterans,” spokesman Amir Avin said in a statement. “Senator Murray will be carefully monitoring the rollout and the timeline and execution of proposed fixes intended to make this system work.”

In interviews with The Spokesman-Review, dozens of employees at Mann-Grandstaff VA Medical Center have expressed frustration with a lack of improvements to the system more than two years after it was launched in Spokane. Despite senior VA leaders being told in October 2021 that an internal investigation had found scores of Inland Northwest veterans were harmed by delayed care caused by the system, the department launched the system at four more hospitals in the first half of 2022.

Glueck said Oracle has made requested changes to the system ahead of schedule, but those changes are only applied on a quarterly basis. Two major and two minor system updates are planned months in advance to allow for testing and are done in February, April, August, and November by the VA and the Defense Department, which shares a database with the VA system, he said in a statement.

“We just do what our client says,” Glueck said, explaining that decisions the VA and Defense Department made to clutter the system’s interface with extraneous options – including a drop-down menu to choose a patient’s species – could be easily changed. “Those are not reasons to pull the system. These are just reasons to fix the system.”

Glueck said changing from the VA’s current electronic health record system, called VistA, will inevitably meet some resistance simply because learning any new system is hard.

“There are a lot of people around the country that use Cerner that love Cerner,” he said. “Because they grew up with it, they know it, they understand it. We need to unpack how much of this is ‘I don’t want to change’ versus how much of this is the usability of the system. Because it’s not like VistA is any more usable, it’s just more familiar.”

Another factor that can’t be ignored, Glueck said, is that the VA chose to deploy the system in Spokane in the midst of the COVID-19 pandemic.

“If you had to say, ‘Let’s come up with the worst possible time to do this,’ it would probably be during a pandemic,” he said. “Nobody anticipated that, so it’s nobody’s fault. Nobody should be held accountable for doing that.”

The fate of the system may depend in large part on Oracle’s capacity to deploy its massive workforce. Glueck said Oracle has some 160,000 employees and has added about 30,000 more with the acquisition of Cerner, but he admitted that building a computer system is different when veterans’ lives depend on it.

“If you replace a banking system, which we’ve done a lot of,” he said, “what’s the worst that happens? Somebody loses an account. Here, people say ‘patient safety.’ Well, in fairness, the entire system is about patient safety, so of course there needs to be a whole lot more care and attention paid.”