Setbacks with new health records system have ‘shaken’ VA secretary

Medical records are filed at the 341st Medical Operations Squadron personnel reliability assurance program clinic Jan. 30, 2017, at Malmstrom Air Force Base, Mont.


Veterans Affairs Secretary Denis McDonough acknowledged that his confidence in the department’s new $16 billion electronic medical records system “has been shaken” by more setbacks, including new evidence that the changeover has resulted in dangerous medical complications for some patients.

“I do now know there were instances of patient harm,” McDonough said at a press conference on Wednesday. “There could be a range of factors that contribute to that, but the patient safety team here at VA can’t rule out that the electronic health records have played a role in that.”

McDonough’s comments came less than a week after department officials announced they would delay deployment of the Oracle Cerner Millennium software to new sites in Oregon and Washington until 2023, and push back deployment to medical offices in Idaho until next month.

Officials said those moves would “allow Oracle Cerner to put important system enhancements in place and make the necessary improvements to ensure system stability … as well as fix outstanding issues to address research workflow challenges.”

But a day later, the Spokesman-Review reported that a draft inspector general report had found at least 148 veterans were harmed by medical record mistakes and shortfalls after the system was implemented at initial sites in Washington state last year.

The newspaper said that the system failed to deliver more than 11,000 orders for specialty care, lab work and other services, all without alerting health care providers the orders had been lost.

McDonough acknowledged the report is being finalized and would not directly comment on the inspector general’s findings.

But he did acknowledge for the first time that the records system caused significant problems in veterans’ care, a line that in the past he has said would lead him to halt deployment in the interest of patient safety.

The 10-year, $16 billion records overhaul was put in motion by President Donald Trump and was meant to bring veterans’ health records in line with military files. In the past, the two agencies used separate records systems with intermediary programs to transfer data between them, causing information issues for patients and physicians.

Pushing new sites back to 2023 is the latest in several delays in the deployment schedule, including a full stop of the program in summer 2021 to evaluate other training and operation concerns raised by the inspector general.

McDonough deflected questions about what VA will do if the records system cannot meet department standards for accuracy and reliability.

“Right now, we’re trying our best to make this Cerner option work,” he said. “Because we all believe the best thing for our patients’ outcome, for patient safety and for our clinicians’ practice is a well-functioning electronic health care record.”

Earlier this week, officials from Oracle Cerner released a statement saying they are making technical changes in the system “with an emphasis on patient safety, to ensure the system exceeds the expectations of providers, patients, and the VA.” They also promised to put “substantially more resources to this program” in coming months.

But lawmakers have grown increasingly frustrated with the setbacks and growing reports of potential medical complications caused by the new system.

On Wednesday, before McDonough’s press conference, House Veterans’ Affairs Committee Chairman Mark Takano, D-Calif., and the panel’s technology panel chairman Frank Mrvan, D-Ind., called the draft reports “seriously troubling,” especially in light of upbeat assessments about the records system delivered to Congress by VA officials in recent months.

“We have already begun discussions with VA on the performance of Cerner and requested an official briefing on the forthcoming report,” the pair said in a statement. “Once released, we will be reviewing the findings closely in order to determine if there are any contractual or legal repercussions of these [inspector general] draft findings.”

VA officials said despite the controversies, they still plan to begin use of the new records system at the Boise VA Medical Center on July 23. Staffers in Ohio began using the system earlier this spring.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.



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Tony Beasley
Tony Beasley writes for the Local News, US and the World Section of ANH.