The new $16 billion electronic health records system rolled out by the Department of Veterans Affairs’ is the subject of a scathing series of reports by the VA Office of Inspector General (OIG).
Electronic health record (EHR) systems have largely replaced paper-based records in the US. The transition to digital records has been bumpy, plagued by problems with health portals, inadequate communication capabilities, and bulky digital documents in which providers may miss important information. Nonetheless, EHRs aim to provide healthcare teams with an integrated view of the history, treatment, and status of their patient.
The new EHR was developed by Cerner for the VA and launched in November 2020 in Spokane, Washington. Initially projected to cost $10 billion, the system picked up an additional $6 billion in order to upgrade tech at member hospitals.
The difficulties reported in three reports delivered by the OIG are staggering:
- Difficulties transferring data led to inaccurate medication lists and contact information.
- Faulty processes around medication allow RNs to enter medication orders without physician orders
- Medications were discontinued by the system without an order from a doctor.
- Erroneous and incomplete medication lists required extensive work-arounds – potentially causing serious medication error.
- Flags on patient records including those at high risk for suicide did not transfer to the new EMR.
- Problems with patient scheduling, follow-up, and disappearance of lab orders delayed timely treatment.
- Between October 2020 and March-end 2021, new users submitted more than 38,700 tickets. The OIG found usage problems with the platform, process challenges, and other deficiencies. The platform was offline for 20 hours in March resulting in treatment and clinical deficiencies.
Senator Patty Murray (Washington state) asked the VA to postpone further roll-out of the system in her state until the global difficulties could be addressed. Instead, the VA pushed ahead and launched the system in Walla Walla, Washington, and in Columbus, Ohio.
In a grossly underwhelming response, representatives from Cerner have indicated to legislators they are considering a “technical review of the EHR to ensure the system is stable and reliable.”
While it is unclear whether the system has yet caused or contributed to death or serious injury, it may be only a matter of time until VA patients suffer the consequences of the poorly-designed EHR built at their expense.
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