VA plans new health record deployments, despite critical watchdog reports

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Two upcoming go-live dates for the Cerner health record at VA facilities in Washington and Ohio will proceed on schedule, the agency says.

Three highly critical oversight reports released this week will not delay plans to deploy Cerner electronic health record software at Veterans Health Administration facilities in Washington State and Ohio over the next two months, the agency said a statement.

The Office of Inspector General at the Department of Veterans Affairs issued three reports on March 17 pointing to deficiencies in the implementation in the agency's Electronic Health Record Modernization effort – a $21 billion-plus, decade-long push to replace VA's homegrown health record system Vista with a commercial system from Cerner that is also being deployed at the Department of Defense.

The reports found that flaws in medication ordering, appointments scheduling and reminders, referrals, care coordination and more are increasing risks for VA's patient population. Additionally, weaknesses in the help desk services provided under the contract with Cerner are pushing VA clinicians into developing time-consuming and error-prone workarounds rather than waiting for the resolution of their service requests.

According to a statement from a VA spokesperson, VHA and the Electronic Health Record Modernization Integration Office "are actively working to evaluate all identified problem sets and develop action plans for any unresolved issues." 

VA is "on track" for deployments of the new system to go live at Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, Wash., on March 26 and the VA Central Ohio Healthcare System in Columbus, Ohio, on April 30.

Currently, the Cerner system is live at the Mann-Grandstaff VA Medical Center in Spokane, Wash., and is also in use in four outpatient clinics affiliated with Mann-Grandstaff and a back-office account center in Las Vegas. The system went live at Mann-Grandstaff on Oct 24, 2020.

The OIG reports contained multiple recommendations to VA for remediation, and in reply comments included in the reports, VA Deputy Secretary Donald Remy indicated that substantiated and unresolved findings would be addressed, with some targeted for completion next week and others to be finished by May 10. 

The OIG report did not call for a pause on future deployments.

Rep. Cathy McMorris Rodgers (R-Wash.), who represents Spokane and Walla Walla in Congress has been calling for a pause on the Walla Walla go-live since this February.

"Cathy is deeply concerned about the findings in the OIG reports released yesterday, " said Kyle VonEnde, a spokesperson for Rodgers, in an email to FCW. "They confirm what she has been saying all along: the electronic health record system has serious issues that need to be resolved. Until then, its rollout to the Walla Walla VA must be delayed."

Rep. Frank Mrvan (D-Ind.), who chairs a House Veterans Affairs Committee panel that focuses on oversight of the EHRM project, is also concerned about the reports, but stopped short of calling for a pause in deployments.

"Patient safety is our number one priority, and these reports from the VA OIG are very troubling and coincide with what staff in Spokane told me last fall," Mrvan said in a statement.  "I remain grateful for all of the dedicated VA staff who have been fighting to make this system work, but these reports make clear that there are significant issues with the implementation."

Mrvan announced a subcommittee roundtable to be held April 5 to hear from clinicians and leadership at the Walla Walla and Columbus facilities as well as  a hearing on April 26 focused on the reports themselves to include VA leadership, contractors and the Office of Inspector General.

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