Why large EHR installs are like 'trying to fix a plane while flying'

Daniel Barchi, CIO of Chicago-based CommonSpirit, said large electronic health record implementations often have problems that are far more than just technical, Politico reported July 21.  

"[It's] like trying to fix a plane while flying," Mr. Barchi told the publication. "A project of this size is enormous, and the problems are far more than just technical. They're about workflow, process and people."

One example of a large EHR implementation that has been hit with problems is Cerner's Department of Veterans Affairs project. The VA has been working to overhaul its previous EHR system, VistA, with a new one provided by EHR vendor Cerner, which was acquired by Oracle in 2022. 

The project, which has been ongoing since 2015 when the VA awarded an EHR contract to Cerner, has been halted indefinitely due to outages with the system and patient deaths

House Veterans' Affairs Chair Mike Bost, R-Ill., called the project a "nightmare," and several high-ranking former officials in both the Trump and Biden administrations told Politico that leadership was partly to blame. 

The officials told the publication that leadership during the Trump administration was "ill-equipped to handle the transition, given lack of experience in EHR overhauls."

The VA serves 9 million patients and has more than 170 medical centers. Only five VA medical centers have rolled out the Cerner EHR system.

It is unknown when the VA will resume the rollout as it has to ensure that the five facilities who have the EHR system are deemed "highly functioning" before continuing the project.

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