by John R. Fischer
, Senior Reporter | November 24, 2021
Problems have once again surfaced around the implementation of the VA’s new EHR system, a $16 billion project being built by Cerner for the last three years.
Issues found within the EHR’s scheduling platform “reduced the system’s effectiveness and risked delays in patient care” according to a new report made public last week by the VA Office of Inspector General. It added that the VA was aware of these “significant” limitations prior to installing the system last year in Spokane, Washington and Columbus, Ohio.
Among the problems was the inability to change appointment types, with schedulers having to manually create a new one or ask the provider to submit a new order. They also could not mail appointment letter reminders automatically, a feature that was available on the old system. Additionally, the new system did not have oversight reports that were previously accessible to track and monitor patient wait times, according to Modern Healthcare
Assessments made the VA’s Office of Electronic Health Record Modernization aware of these performance malfunctions, but they were not fully resolved before the system went live in Columbus. Even more issues arose after the system was installed there but were not resolved before it went live in Spokane. This included missing information for clinics, appointment types and providers; the inability of some schedulers to schedule appointments; and data from the VHA’s old system not being properly or completely transferred to the new one when deployed at both locations. Automatic appointment calls also had to be turned off, because they were providing misleading information.
"Facility staff said it generally took more than a week for Cerner to close help tickets, unnecessarily delaying some patients' care," said the report.
The VA had planned to implement the new scheduling system at all facilities by December, but this idea was pushed back in March when a strategic review of the full program was launched.
VA leaders did not provide scheduling staff with enough opportunity to identify these limitations and lacked a mechanism for determining if Cerner was complying with the timeline requirements of its contract, according to the OIG. It recommended in its report that the VA resolve the issue “as soon as possible, ideally before deploying any more of the new EHR system at future facilities.” It suggested improving training for scheduling; engaging schedulers better in testing and improvements; issuing guidance on measuring patient wait times; tracking help tickets consistent with contract terms; developing a strategy to promptly resolve identified issues; developing oversight of schedulers’ accuracy; evaluating patient care timeliness; and providing guidance to consistently address system limitations.