This story was updated on Friday, March 19, 2021 at 12:50 pm, with additional statements from Cerner Corporation and members of Congress.
The Department of Veterans Affairs will launch a 12-week strategic review of its electronic health record modernization program, the agency announced on Friday.
“A successful EHR rollout is essential for providing world-class lifetime health care for our veterans,” said VA Secretary Denis McDonough in a statement on Friday. “After a rigorous review of our most recent deployment at the Mann-Grandstaff VA Medical Center, it is clear that a strategic review is needed. VA remains committed to the Cerner Millennium solution and we must get this right for veterans. “
VA delayed the initial launch of the Cerner Millenium EHR suite twice last year – once to allow for more training and then because of COVID-19.
The department finally launched the new EHR last October at its first location, the Mann-Grandstaff VA Medical Center in Spokane, Washington, and said the deployment was successful.
But the department said its ongoing analysis of the situation in Spokane “precipitated the need for a timetable change”.
VA was due to launch the new EHR at its medical center in Columbus, Ohio, where the department had already launched Cerner’s centralized programming system (CSS) last summer.
That could change after the VA’s next review, the department said on Friday, although it didn’t go into much detail.
Congress has expressed concern in the past about the VA’s implementation schedule, after the department postponed its initial start-up in Spokane, but maintained its 10-year long-term schedule for the entire project.
The department said it will focus on finding additional productivity and optimizing clinical workflow at Mann-Grandstaff and other future sites and seeking further improvements to the patient portal that veterans use, as well as “data distribution and cycle improvements. of revenue “
The VA review comes when Rep. Cathy McMorris-Rodgers (R-Wash.), Whose district includes Spokane, raised concerns about the new electronic health record for the new secretary.
“When deciding how to proceed with Cerner’s electronic health record, I hope you keep in mind the real-life experiences of VA veterans and employees in eastern Washington,” she wrote in a March 17 letter to McDonough. “The system is not an improvement, at least not yet.”
She continued to detail how VA doctors have struggled to use the new platform to fill prescriptions. Some veterans are not receiving their prescriptions when needed or are receiving the wrong ones.
“This appears to be especially problematic when information from veterans’ health records is confused with Cerner EHR at Fairchild Air Force Base,” said McMorris-Rodgers. “I have a report from a VA doctor who prescribed two drugs to a veteran, but he received 15 wrong drugs. I have several reports of delays in prescriptions, which, in one case, caused a veteran to experience abstinence. These impacts are dangerous and unacceptable. “
Cerner’s patient portal is also confusing for veterans in Spokane, and appears to be less functional than the VA patient portal, said McMorris-Rodgers.
Challenges with the new platform are also reducing employee morale, she added.
“I’m hearing from some who are deeply frustrated with the system and are not getting the support they need,” wrote McMorris-Rodgers. “Nurses who go to work every day to serve our veterans should not be moved to tears because the software, which was created to be an improvement, makes their job more difficult.”
Mann-Grandstaff hired additional clinical staff to help make up for the productivity delays that the new EHR can cause inevitability, but McMorris-Rodger said those personnel gains are over. She said her local VA medical center experienced particularly high levels of turnover in the past year, with the primary care sector having a 60% turnover in staff.
The presidents and senior members of the VA House and Senate committees also described their concerns about the EHR modernization program in a February 25 letter to McDonough.
Richard Stone, VA’s acting undersecretary of health, traveled with a group of department leaders in late January to observe the challenges in Mann-Grandstaff, members of Congress said. Spokane hospital staff, as well as VA and Cerner staff, formed “tiger teams” to diagnose and resolve usability problems with the EHR platform, they added.
McDonough acknowledged that VA employees at Mann-Grandstaff worked hard to deploy a new electronic record during a particularly challenging year.
“Our dedicated VA professionals continue to work feverishly in this effort, even as we maneuver through the complexities and outbreaks of the COVID-19 pandemic,” he said on Friday.
Cerner Corporation said it supported the VA’s decision and welcomed the opportunity to review the lessons learned.
“Our number one priority remains the veterans we serve and deliver solutions that drive the transformation of service across the VA,” said Brian Sandager, general manager, Cerner Government Solutions. “We are proud of the significant milestones we have achieved, including one of the largest health data migrations in history and the implementation of a new joint health information exchange between DOD, VA and their community partners.”
The leadership on the House and Senate Veterans Affairs Committees also said they were happy that VA heard the concerns of VA veterans and employees in Spokane.
The chairmen and senior members of these committees wrote to McDonough last month, asking him to reconsider the way forward for the EHR modernization program.
“Pausing the implementation of Cerner’s new electronic health record is a good decision,” said Mike Bost (R-Ill.), A senior member of the House Veterans Affairs Committee, on Friday. “This effort may revolutionize VA service, but it is not on track today. VA must fix the serious problems in Spokane. VA must also address the process, strategy and management challenges that led to these problems before moving on anywhere else. “
The VA House Committee will host a hearing next month on the status of the EHR modernization, said Frank Mrvan (D-Ind.), Chairman of the technology modernization subcommittee.