Report Summary

Title: The Electronic Health Record Modernization Program Did Not Fully Meet the Standards for a High-Quality, Reliable Schedule
Report Number: 21-02889-134 Download
Issue Date: 4/25/2022
VA Office: Electronic Health Record Modernization Integration Office
Report Author: Office of Audits and Evaluations
Report Type: Audit
Release Type: Unrestricted

VA is replacing its aging electronic health record system with a new one intended to be interoperable with the Defense Department to give healthcare providers a continuous and comprehensive medical history for veterans. The Electronic Health Record Modernization (EHRM) program is expected to take about 10 years to implement across VA facilities, with projected completion in fiscal year 2028.

The Office of Inspector General (OIG) audited the EHRM program’s master schedule as part of its continued oversight of this costly and complex effort and identified reliability weaknesses. The audit team found VA lacked a reliable integrated master schedule consistent with scheduling standards, which increases the risk of missing milestones and delaying the delivery of a system to support prompt quality care to veterans. Schedule delays that extend the program are also likely to result in about $1.95 billion in cost overruns per year and may undermine VA’s other modernization efforts on supply chain and financial management systems.

Additional deficiencies included known tasks not being reflected on schedules, no risk analysis, lack of longer-term actions scheduled, and no complete baseline schedule or overall schedule that fully integrated individual project schedules. VA also did not comply with federal regulations when it paid its contractor for deliverables before accepting them (reviewing for compliance with contract requirements).

VA concurred with the OIG recommendations for the EHRM program office to comply with internal guidance and develop an integrated master schedule that meets standards, improve stakeholder coordination to ensure activities from all relevant VA entities are included, implement procedures for performing schedule risk analyses, make contract language and program office plans or other guidance consistent, evaluate and modify contract requirements for schedule management to clarify roles for further schedule development and maintenance, and issue guidance to accept deliverables not separately priced before invoice payment.

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