VA to resume implementation of Cerner medical record early next year with new leadership

Dive brief:

  • The Department of Veterans Affairs plans to restart its system-wide implementation of a new electronic health record early next year, but has reshuffled its leadership team following congressional anger, snowballing spending and concerns about the safety of patients, managers announced wednesday.
  • The changes came when the VA released the results a four-month investigation into the $ 16 billion project. Managers have planned for more comprehensive worker training and a scheduled rollout of the Cerner system to all VA facilities through 2024.
  • The project, intended to consolidate all VA, Department of Defense, and Coast Guard facilities on the same EHR system, came under scrutiny by Congress and was suspended in July at the following implementation issues at Mann-Grandstaff VA Medical Center in Spokane, Wash.

Dive overview:

Mann-Grandstaff went live in October of last year, the first site to cross the finish line in a project plagued by delays, growing expense and operational issues since its launch in 2018. Following multiple delays during COVID-19, the VA chose to pause the program indefinitely over the summer pending a rigorous internal review, following surveillance reports highlighting high spending and poor staff training during from the first launch of the disc.

VA Deputy Secretary Donald Remy said on Wednesday his department incorporated lessons learned from meetings with the Mann-Grandstaff team in the new leadership.

“We will do everything possible to make electronic health records suitable for veterans and our healthcare staff, with patient safety being the key and non-negotiable factor,” Remy said in a statement.

VA Inspector General’s Office found earlier this year that VA and Cerner had not provided sufficient training to clinicians and administrative staff on the Cerner Millenium EHR before putting it online, which could have compromised the quality of patient care. The majority of hospital staff interviewed said they were unable to document patient care on file or navigate the EHR without having issues.

And another report discovered that VA had failed to calculate a reliable life cycle cost for the program. Previously, the agency estimated that the entire project would cost $ 16.1 billion over 10 years. However, OIG said that estimate was not accurate, completely leaving out at least $ 2.5 billion in critical infrastructure upgrade costs for modernizing existing systems already in place.

Members of the Congressional Technology Modernization subcommittee said they supported the hiatus during a hearing in July. They were concerned about the potential risks to patient safety and the findings of the reports.

In the VA report released on Wednesday, officials focused on governance as an urgent need for the project. VA officials unveiled a leadership reorganization in an effort to streamline management, including a new program executive director to coordinate operations. Officials are also creating a new deputy chief information officer to oversee the integration of the technology.

VA is also planning additional training on the new system, including more practice time for staff with the system before it is used in a clinical setting. The agency is also introducing an EHR training environment to better familiarize clinicians with the system in a real-world setting.

Before the break, the next site scheduled to go live was a VA Medical Center in Columbus, Ohio. This installation is always next on the agenda. The deployment is expected to begin again there in March, followed a few weeks later by a VA medical center in Walla Walla, Washington.

According to the new tentative schedule, the Cerner Millenium system will be operational in 12 VA medical centers by the end of next year, and 21 more by the end of 2023. Optimistically, the entire VA network, including 170 hospitals and over 1,000 outpatient sites are expected to be operational with the new system by 2028.

However, “future deployments, adjustments and / or schedule changes will be made based on any additional clinical and technical findings and will continuously take into account the effects of the ongoing COVID-19 pandemic,” officials have warned.

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