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TND: Can VA save troubled electronic health records system?

Mission Roll Call 4 min read April 18, 2023
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This article originally appeared on The National Desk

(TND) — The rollout of a new electronic health records system for veterans is stalled and riddled with what one advocate called “systemic failures,” despite years of work and billions of dollars in investment.

Cole Lyle, a former Marine and the executive director of advocacy group Mission Roll Call said this program is much needed as an update to the Veterans Affairs’ current, outdated health records system.

But the new program is on shaky ground, over budget, over time, and blamed for patient harm.

“Congress has said we need to find a creative solution to fix this,” Lyle said. “The VA itself has said we’re going to hold the contractor accountable, and the contractor has said we’re working diligently on fixes, and we’re making progress. But year over year, we still don’t see much improvement and or progress.”

VA officials this month decided to delay the health records software implementation at facilities in Michigan, according to Military Times.

And lawmakers have introduced legislation that would prevent the continued deployment until significant improvements are made to the system.

The VA’s electronic health records project began in 2017 with the goal of having better access to patient charts from the Department of Defense.

Lyle said they wanted to improve the continuity of care both during and after a patient’s military service.

But the rollout, which started in 2020, has only reached five locations in the vast VA health care system, which includes over 170 medical centers and over 1,100 outpatient clinics.

Sen. Jerry Moran, of Kansas, is leading a group of a dozen Republican lawmakers in calling for fixes and accountability before more VA sites get the new health record system.

Moran, the lead Republican on the Senate Committee on Veterans’ Affairs, is sponsoring new legislation and said it is “clear that the (electronic health record) system is putting veteran patients at risk and creating significant challenges for VA staff.”

A report from the VA Office of Inspector General blamed the new system for nearly 150 cases of harm to patients at the VA’s Spokane hospital, which was the first VA facility to go live with the new system.

The system also failed to deliver more than 11,000 orders for requested clinical services, such as radiology or scheduling appointments, potentially delaying care for patients.

The lack of care the department has provided to veterans impacted by the new system is unacceptable,” Moran said in a news release.

He and Sen. Jon Tester, a Democrat and the chair of the Senate Veterans’ Affairs Committee, introduced a different bill last year that was signed into law by President Joe Biden to increase transparency around this VA program.

A recent Government Accountability Office report also highlighted concerns by VA staff over training on the new system and decreased morale.

Other lawmakers have said the rollout should be paused as long as needed to ensure it really works.

“That may be years, but the delivery of good care and services to veterans depends on it,” reads part of a statement from House Committee on Veterans’ Affairs Chairman Mike Bost and Rep. Matt Rosendale, both Republicans.

Lyle’s group, Mission Roll Call, polled veterans on the electronic health records program.

Most folks, 83%, want the program to remain paused until improvements are made as opposed to scrapping it altogether.

Lyle said no one wants to throw good money after bad, but there are also serious questions about whether the VA and its vendor, Oracle Cerner, can come through with a good product.

The VA opted to adopt a similar platform designed by the same company as the one used by the DOD, though it acknowledged in 2017 that the VA has unique needs from those of the DOD.

Lyle said the vastly different patient populations have been a big problem.

There are about 1.5 million current service members.

There are about 18 million veterans, about half of which are enrolled in VA health care.

And veterans as a group are older than active military members, less healthy and more spread out, Lyle said.

“You have much different health care needs,” he said.

Can the VA’s new electronic health records system be saved?

Lyle said he hopes so, but he’s not optimistic.

“It’s only in five facilities, and none of them are really a large metropolitan facility,” he said. “What happens when you roll it out and these problems aren’t fixed?”

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