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VA Reassessing EHR Rollout Strategy Over Concerns at Pilot Facility

VA Secretary halted its EHR rollout until deployment sites show that they have adequate infrastructure and training for the EHR implementation.

VA Secretary Denis McDonough said the agency is rethinking its EHR rollout strategy after watchdog reports revealed health IT-related patient safety issues at the pilot facility last month, according to reporting from The Spokesman Review.

McDonough told the Senate Committee on Veterans Affairs on Wednesday that he would not let other hospitals adopt the new EHR system until problems at the Mann-Grandstaff VA Medical Center are fixed and upcoming deployment sites in Washington, Idaho, and Oregon demonstrate they have the physical infrastructure and EHR training necessary to implement the system.

However, he declined to say how much longer the pilot site’s hospital’s staff and the 30,000 veterans they serve will need to deal with the health IT glitches that have ushered in patient safety concerns and workforce frustrations.

The VA chief noted that bad management and planning caused the problems, not the EHR software from Cerner Corporation.

“Most challenges were not breakdowns in the technology, nor of the great people at Mann-Grandstaff who did the best they could in the worst of circumstances,” he explained. “Instead, the missteps were ours’ at VA and Cerner, and now that we’ve identified those problems, we can solve them.”

The Trump administration awarded the EHRM contract to Cerner in 2018 without going through a competitive bidding process, as the vendor was already developing an EHR for the Pentagon for the MHS Genesis project. However, MHS Genesis caused similar patient safety issues during its roll-out.

Senator Patty Murray, a Washington Democrat who sits on the VA Committee, told McDonough that when Cerner won the contract in 2018, she had warned of implementing an EHR that had caused patient safety concerns in a previous federal implementation.

Murray told McDonough, who was selected by President Joe Biden to lead the VA, that while she understood he was not at fault for the poor EHR rollout, she expected him to fix it quickly.

Alabama Republican Senator Tommy Tuberville likened McDonough’s position to taking over a football program and being expected to win without a quarterback or offensive line.

A separate Office of Inspector General (OIG) audit released last week found the VA and Cerner failed to adequately train employees at the pilot site before deploying the new EHR last October.

What’s more, when asked for data surrounding employee efficiency with the new system, the agency altered data to show that 89 percent of end-users had passed proficiency tests, when in reality just 44 percent had shown proficiency with the EHR implementation.

McDonough noted that he would revamp the organizational structure for EHRM management and suggested that those responsible for doctoring the test data could lose their jobs.

The inspector general’s report also found that VA and Cerner failed to build the physical infrastructure necessary for the new system.

“This report makes clear the Electronic Health Record Modernization program needs strong oversight by VA and Congress to ensure it delivers reliable support to Department medical staff and the veterans they serve,” Jon Tester, chairman of the Senate Veterans’ Affairs Committee, said in a statement at the time of the audit’s release.

Congress will maintain its oversight of the EHR rollout at Mann-Grandstaff in a hearing of the House VA Committee set for next Wednesday.

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