'I hope Cerner's watching this': VA, lawmakers chew over what went wrong as EHR timeline halted

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The Department of Veterans Affairs is scrapping its Cerner EHR deployment timeline, as lawmakers decipher what went wrong and if Cerner is the right EHR vendor for the VA, according to a July 14 Federal News Network report.

In a hearing before the Senate VA Committee, VA Secretary Denis McDonough said the department discovered "numerous patient safety concerns and system errors" with Cerner's EHR program.

Ten things to know:

  1. Mr. McDonough emphasized that the hiccups the rollout has encountered were not the fault of the VA's hospital staff, but the missteps of VA and Cerner leadership.

    "Most challenges were not breakdowns of the technology, nor of the great people at [Spokane, Wash.-based] Mann-Grandstaff who did the best they could in the worst of circumstances, implemented this program in the heart of a pandemic, dutifully shared findings that improved the system and ensured that our veterans were safe despite the challenges they faced," Mr. McDonough said. "Instead the missteps were ours, at VA, and Cerner."

  2. Mr. McDonough described stories he heard from employees during his visit to the Spokane VA hospital that illustrated the lack of training available for hospital staff.

    "I heard from another clinician that help with the new platform wasn’t always easy to find, even when you asked for it," McDonough said. "When she called the Cerner help desk, the person on the other end of the line told her he had just started a week prior. In other words, she had more experience using the platform than the person who was supposed to help her navigate it."

  3. Recent audits have found several key factors that affected the $16 billion EHR rollout. Mr. McDonough said these findings are "extremely disappointing." Moving forward, the VA will "reimagine" the approach in its rollout and the entire timeline will need to be refreshed, Mr. McDonough said. He said there will be an enterprise-wide governance structure responsible for managing the modernization effort.

  4. The VA deputy secretary is supposed to be in charge of the EHR project. The last one stepped down, and the Senate has yet to confirm nominee Donald Remy. Mr. McDonough wants to hold off on making any big decisions until he can speak to the incoming deputy secretary.

  5. The VA was supposed to be synchronized with the Defense Department while they modernize their EHR for active duty families. The DOD is now ahead of the VA, and Mr. McDonough called the geographic deployment plan a mistake. The VA will develop an entirely new schedule for the rollout. Instead of rolling them out by region, they will be launched only in hospitals deemed ready. The hospital must have the updated infrastructure required, thoroughly trained employees and proper leadership in place.

  6. The VA is also upping its $16 billion budget since the last one was inaccurate and unreliable, the VA told senators.

  7. Senators expressed several concerns about Cerner's role in the rollout. For example, it disrupted the VA’s billing operations because the Cerner program doesn’t have an "effective revenue cycle function." There are still many parts of the claims and payments process that require manual entry, Mr. McDonough said in a written testimony.

  8. "I hope Cerner’s watching this," said Jon Tester (D-Mont.), chair of the Senate Veteran Affairs Committee. "If Cerner’s not up to making a user-friendly electronic medical record, and, in fact, what’s transpired here is we’re going in the opposite direction, then they ought to admit it and give us the money back so we can start over."

  9. Multiple senators questioned if Cerner is the right EHR vendor for the VA, Federal News Network reported.

    "I think the technology is basically sound," Mr. McDonough said. "So much of these technology questions in terms of execution really end up being governance and management challenges, which is why I think it’s on me. I have not yet found and I don’t believe I will find an answer that says the technology is wanting. On this question of the three data pools, we have the best data scientists in government, and we’re going to fix that."

  10. Regardless of the challenges the VA has encountered with its rollout, Mr. McDonough has been confirmed for the position, with lawmakers noting he inherited the VA's challenges, Federal News Network reported.

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