A turbulent yr, and a retooled future, for the VA’s EHR rollout

[Ed. note: This story has been updated to include a statement from Cerner.]

In August 2020, the U.S. Division of Veterans Affairs went reside with the primary part of its Cerner-developed digital well being report on the VA Central Ohio Healthcare System in Columbus.

Two months later, it rolled out the brand new EHR on the Mann-Grandstaff VA Medical Middle in Spokane, Washington.  

The strikes represented main progress for the multibillion-dollar Digital Well being Report Modernization challenge, which had confronted quite a few delays as a consequence of COVID-19 and different components.   

However that development was short-lived: The initiative has now had quite a few setbacks, with management repeatedly dropped at testify earlier than congressional committees and quite a few watchdog stories zeroing in on budgetary issues and coaching considerations. 

All through all of it, Healthcare IT Information has continued to cowl the division’s efforts. Learn on for a recap of the initiative’s headway to this point and to seek out out extra in regards to the VA’s latest plan introduced simply this previous week.  

The Mann-Grandstaff response  

In March 2021, Rep. Cathy McMorris Rodgers, R-Washington, wrote a letter to VA management describing the complaints she had heard in regards to the new system at Mann-Grandstaff and asking for an investigation.

McMorris Rodgers cited alleged issues with affected person security, comparable to veterans getting the improper prescription, and with the Cerner affected person portal.  

In response to those and different considerations, the VA mentioned it could undertake a strategic evaluation of this system and would pause different go-live actions within the meantime.  

What the evaluation discovered  

That 90-day evaluation revealed a number of excellent points, as VA Secretary Denis McDonough instructed the Senate Committee on Veterans Affairs in July.  

The problems recognized concerned affected person security, productiveness, governance and administration, value, affected person portal expertise, testing, knowledge and alter administration.  

Lawmakers weren’t impressed.  

“Frankly, I for one am fed up with the quantity of taxpayer {dollars} we’re spending on this program with none demonstrated advantages to veterans or VA medical workers,” mentioned Sen. Jon Tester, D-Montana, throughout one listening to.  

Though McDonough had mentioned the company would keep the course with Cerner, he additionally mentioned it deliberate to reimagine its method.  

That very same week in July, Cerner executives instructed the Home Veterans’ Affairs Subcommittee on Know-how Modernization that the corporate was “dedicated to getting this proper.”    

In the meantime, VA Assistant Underneath Secretary for Well being for Discovery, Training and Affiliate Networks Dr. Carolyn Clancy mentioned the company would cease additional deployments till subsequent yr.  

The Workplace of Inspector Basic stories  

All through this course of, the VA OIG has launched a number of stories flagging points with the challenge.  

In Could, for instance, it discovered that the company had underestimated the price of the initiative by billions of {dollars}.  

One other report, revealed in July, centered on unreliable IT infrastructure value estimates, whereas a 3rd from that very same month pointed to coaching deficiencies.  

And a fourth, which got here down in November, mentioned the scheduling system wants work.  

What now?  

VA has continued to push the challenge alongside. Leaders have repeatedly appeared earlier than congressional committees, going through pointed questions round funding and affected person security.  

In September, the company allotted $134 million to Cerner to go towards deployment actions on the Louis Stokes Cleveland VA Medical Middle and the John D. Dingell VA Medical Middle in Detroit.  

The next month, it partnered with the Institute for Protection Analyses to offer an evaluation and full value estimate of the initiative.  

And in November, the White Home introduced its nomination of former Microsoft government Kurt DelBene as chief info officer and assistant secretary for info on the VA. If confirmed by the Senate, DelBene may take an energetic function within the modernization efforts.  

That is not the solely new function on the company specializing in the challenge. Simply this previous week, the VA introduced a retooled plan that included a revised EHR administration construction, a strengthened Workplace of the Useful Champion, a brand new deputy chief info officer for EHR and a newly established program government director for EHR Integration place. 

That latter place can be crammed by Dr. Terry Adirim, at the moment serving because the appearing assistant secretary of protection for well being affairs. The VA additionally introduced that it deliberate to go reside in Columbus in March 2022, with one other deployment tentatively scheduled for Walla Walla, Washington, that very same month.  

Altogether, 11 extra deployments are on the calendar for 2022, wrapping up with the power in Portland, Oregon, on November 5.  

As well as, the company launched a “complete classes realized” progress replace, reflecting on the strategic evaluation and establishing a brand new path ahead.  

“We are going to do all the pieces we will to get digital well being data proper for Veterans and our well being care workers, with affected person security being the important thing driver and non-negotiable,” VA Deputy Secretary Donald M. Remy mentioned in an announcement.   

“I’ve integrated the teachings realized I obtained throughout my current conferences with our group at Mann-Grandstaff VA Medical Middle in Spokane, Washington, into this new method ahead,” he continued. “Underneath my route, VA is refining EHR governance and administration buildings to ascertain extra rigor and oversight.  

“VA, in coordination with our companions, the Division of Protection and EHR vendor Cerner, will proceed to replace and refine the EHR implementation course of to make sure it delivers the excellence veterans anticipate and deserve from VA,” he added.

“Cerner has and can preserve onsite help at Mann-Grandstaff. We stay dedicated to Secretary McDonough, the suppliers and workers, and veterans,” mentioned Brian Sandager, normal supervisor and senior vp of Cerner Authorities Companies, in an announcement despatched to Healthcare IT Information after preliminary publication. ​”Cerner will proceed partnering with VA to achieve entry to the location, guaranteeing this system continues to maneuver ahead efficiently.

“Given final week’s announcement, Cerner shares VA’s sentiment that the brand new governance and management will positively impression this system. We’re on a path to ship world class healthcare for our nation’s veterans and stay up for advancing our partnership and extra deployments in 2022,” Sandager mentioned.

Trying forward at 2022

What the uptick in curiosity and utilization of digital well being will imply for the way forward for healthcare and what to anticipate in 2022 for the trade.

Kat Jercich is senior editor of Healthcare IT Information.

Twitter: @kjercich

E-mail: kjercich@himss.org

Healthcare IT Information is a HIMSS Media publication.

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