Veterans Affairs leaders are completely overhauling their training and deployment schedule for their controversial electronic medical records modernization project, acknowledging fundamental flaws in the work so far.
But VA Secretary Denis McDonough told lawmakers on Wednesday that he is not considering abandoning the $16-billion project to use the Cerner Millennium records platform, a 2017 decision made by then-President Donald Trump, who touted it as the solution to bring veteran and active-duty medical files into the same computer system for the first time.
“The mission of the [project] has always been to create a platform that seamlessly delivers the best access and outcomes for our vets and the best experience for our providers. VA’s first implementation of the records … did not live up to that promise, either for our veterans, or for our providers,” McDonough told members of the Senate Veterans’ Affairs Committee on Wednesday.
“But by making changes, we can and we will get this effort back on track.”
The electronic records project has received intense scrutiny from Congress in recent months, in part because of the cost and scope of the project and in part because of past, expensive failures in efforts to bring the Defense Department and VA together on the same medical records systems.
“I for one am fed up with the amount of taxpayer dollars we’re spending on this program without any demonstrated benefits to veterans or VA medical staff,” said committee chairman Jon Tester, D-Mont. “This simply cannot continue. We have literally been working on this for almost my entire time in Congress, 15 years.”
Last fall, after two years of behind-the-scenes work on data processing and planning, the new VA system went online at the Mann-Grandstaff VA Medical Center in Spokane, Wash.
In a report released last week, the VA Inspector General found that rollout to be a chaotic headache, criticizing “insufficient time for training … challenges with user role assignments, and gaps in training support.”
McDonough said those kinds of reports prompted the department’s recently completed 12-week review of the records changeover plans. In a report released to Congress on Wednesday, VA investigators acknowledged that significant changes are needed because “veterans and their families are frustrated by the transition.”
That includes addressing “numerous patient safety concerns and system errors” identified during the Spokane rollout. McDonough said that staff found that all safety issues were immediately corrected, but the potential for harm because of records mistakes raised extra concerns among leadership.
Improved patient safety was a key selling point of the records overhaul, with supporters asserting that a better records system would cut down on mistaken drug prescriptions and provide physicians with better visibility of patients’ whole health records.
The internal VA review found similar difficulties with training and implementation of new records systems in private-sector ventures, and pointed largely towards issues with how staff and patients were introduced to the new Cerner system than the records system itself.
Officials promised to address all open patient safety issues by the end of this month, before the project advances any further.
Less clear is the timeline for the rest of the project. Officials were supposed to deploy the new records system to the Columbus, Ohio, VA medical center this summer, with an eye towards having the entire department medical system using the new software in 2028.
Instead, VA officials are now planning a “technical-only” deployment of the Cerner technology in two of its regional service networks (the ones encompassing Spokane and Columbus) without any impact on patients or clinicians.
Officials will also abandon previous plans for a site-by-site scheduled deployment of the new system, instead evaluating individual facilities preparations and readiness before putting the new system in place. McDonough did not say when patients and staff should expect those moves.
“I won’t go live at those sites fully until I have answers to all of our questions,” he said.
Senators praised the revamped approach but lamented the continued problems with the program.
“The longer we delay, the longer that we have challenges with this program, the less likely that the veterans who are living today are going to benefit from this dramatic opportunity,” said committee ranking member Jerry Moran, R-Kansas.
“For this to be judged a success, I think the pause was important. We need to produce quality standards for electronic health records, get our VA employees and the practicing medical community trained.”
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