Electronic Health Record Modernization: VA Needs to Address Change Management Challenges, User Satisfaction, and System Issues

Abstract: VA uses the Veterans Health Information Systems and Technology Architecture (VistA), which includes the department's legacy EHR system, to provide health care to its patients. In June 2017, VA initiated the EHRM program to replace VistA because it is technically complex, costly to maintain, and does not fully support the need to exchange health data with other organizations. Specifically, VA began to acquire the same EHR system DOD was acquiring. VA has reported obligating about $9.42 billion on EHRM from fiscal year 2018 through the first quarter of fiscal year 2023. GAO was asked to testify on its recently completed review to determine the extent to which VA has (1) used organizational change management strategies for the EHRM program consistent with leading practices, (2) assessed satisfaction with the new system, and (3) identified and addressed EHR system issues. GAO identified leading change management practices and evaluated VA's activities against these practices.