VA hasn't included all critical stakeholders in $16B EHR modernization, GAO report finds: 7 notes

The U.S. Government Accountability Office released a report June 5 claiming that while the Department of Veterans Affairs' decision-making procedures for its $16 billion Cerner EHR rollout have generally been effective, it has sometimes failed to include the input of key stakeholders.

In June 2017, VA announced its plans to transition to a Cerner EHR, the same system the Department of Defense was implementing. Since then, VA has delayed the go-live for its EHR system multiple times, most recently postponing it indefinitely to focus its efforts on its COVID-19 response.

For its report, the GAO analyzed VA's implementation efforts at Mann-Grandstaff VA Medical Center in Spokane, Wash., where the department planned to deploy the EHR in July 2020 as well as the Puget Sound Health Care System, where it planned to go-live in fall 2020.

Seven report insights:

1. To prepare for its summer and fall 2020 go-lives, VA established 18 EHR councils comprising VA clinicians, staff and other experts and held eight national workshops between November 2018 and October 2019. VA also held eight local workshops at both medical centers to help ensure the EHR configuration supported local practices.

2. At the workshops, the councils decided how to design the EHR software's functionality to help clinicians and staff complete tasks such as administering medication.

3. While the EHR councils included a wide range of stakeholders from various geographic regions, "VA did not always effectively communicate information to stakeholders, including medical facility clinicians and staff," to ensure these groups were at local workshop meetings, two clinicians from initial implementation sites told GAO.

4. Local workshop participants said they didn't always know which workshop meetings they were required to attend because they didn't receive proper information about the session topics, according to the report.

5. Clinicians and department leads from medical facilities that were supposed to participate in the workshops also told the GAO that "differences in the use of terminology between VA and Cerner sometimes made it challenging to identify the clinicians and staff that should attend local workshop meetings." For example, some officials didn't think a meeting on "charge services" was relevant to their work but later learned the meeting covered topics that involved them beyond billing.

6. VA has not indicated how it plans to describe these future workshops and sessions to ensure critical stakeholders participate but the department does plan to hold local workshops before implementing the Cerner EHR at future VA medical facilities.

7. GAO recommended that VA improve communication on workshop meeting topics to ensure the EHR modernization program obtains input from critical facility clinicians and staff to consider when making design decisions for the EHR system.

Click here to view the full report.

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