More than a year after after the test of a new records system began in October 2020, a Spokesman-Review investigation found problems with the system continue to threaten patient safety and have left employees at Mann-Grandstaff VA Medical Center in Spokane exhausted and demoralized, with nearly two-thirds saying in a recent internal survey it has made them consider quitting. (Facebook)
WASHINGTON — A congresswoman for Washington state is requesting the Department of Veteran Affairs delay the rollout of its multibillion-dollar electronic health record system after it recently crashed at Mann-Grandstaff VA Medical Center in Spokane, limiting veterans' services and affecting the records of more than 200 patients.
Rep. Cathy McMorris Rodgers, R-Wash., called for the delay as another Washington-based VA medical center in Walla Walla is scheduled to launch the new record system later this month. McMorris Rodgers said the Mann-Grandstaff shutdown was another in a series of challenges created for VA hospital staff and veterans.
“I stand by the request I made on Feb. 3rd for the go-live in Walla Walla to be delayed until the VA can ensure the facility can maintain the highest levels of service for our veterans, she said in a prepared statement.
McMorris Rodgers wrote a letter to VA Secretary Denis McDonough on Feb. 3, calling for a delay on the system rollout at Walla Walla. She referenced the ongoing issues at Mann-Grandstaff as a reason for the delay.
“If the new electronic health record delivers anything short of the gold-standard, timely care our veterans deserve, then it is not ready to serve the Walla Walla community — not until any and all outstanding issues are resolved,” McMorris Rodgers wrote in her letter.
The VA started to overhaul its electronic health record system in 2017. In May 2018, the agency awarded a contract to Cerner Corp., a health care technology company based in Kansas City, Mo., to make a system compatible with the electronic health records at the Defense Department.
The system breakdown March 3 at Mann-Grandstaff happened amid a routine software upgrade, which caused a jumbling of patient data, according to Paula Paige, director of communications of the VA’s Electronic Health Record Modernization Integration Office. When a VA employee received a patient's record, the system occasionally provided the information from a different patient.
When that happened, Robert Fischer, the director at Mann-Grandstaff, instructed employees to stop using the new electronic health record system, which they utilize to coordinate health care services for patients, according to an email obtained by The Spokesman-Review, which was first to report the incident.
“Assume all electronic patient data is corrupted/inaccurate,” Fischer told employees in the email.
Services continued for patients already admitted to the hospital, but new patients were not admitted. Meanwhile, the hospital’s chief of surgery made assessments in regard to the safety of continuing surgeries.
“Mann-Grandstaff leadership rightly took the system offline until the scope of the problem was understood, so no patients were harmed,” McMorris Rodgers said in her statement.
“It’s absolutely unacceptable that a technical failure by Cerner has led to patients being turned away at Mann-Grandstaff VA Medical Center in Spokane,” Sen. Patty Murray, D-Wash., said in a released statement.
The surgical schedule at the hospital was not terminated because of the computer crash, the VA said.
At the time, Fischer also told Mann-Grandstaff employees to utilize “downtime procedures,” which involved employees writing down patients’ information on paper and entering it into the computer system once the system was working again.
Furthermore, employees were instructed to “make every effort to limit” ordering medications, lab tests and X-rays. Mailings, which include prescriptions, were also suspended.
The system was restored the following morning. However, employees were still unable to access some patient records, The Spokesman-Review reported.
The new electronic health record system is designed to connect the VA’s medical centers and clinics with the Defense Department and the Coast Guard. The connection allows providers more information on a veteran’s medical history and provides a smoother transition from active duty to veteran status.
When the system overhaul began, some lawmakers expressed concerns about the project because of previous failed attempts by the VA and the Defense Department to merge their systems. A previous plan involved upgrading VistA, the VA’s former electronic health record system. However, the plan was abandoned in 2013 due to cost concerns after the VA and DOD spent about $1 billion.
The VA completed a review last year of its new $16 billion project to overhaul the system after hearing concerns from staff in Spokane, where the electronic record system was first implemented.
Staff at the Mann-Grandstaff complained about technical issues with the system that affected patient care and employee morale. When McDonough took office in February 2021, he announced a 12-week pause of the rollout to review the issues. The review revealed patient safety problems, escalating costs, a lack of productivity and ineffective training on the new health care provider system, among other issues.
Last July, the VA promised a new approach for the project to overhaul its health record system, following concerns from federal watchdogs and employees who used the program.
McDonough testified in July before the Senate Veterans’ Affairs Committee about the challenges and the department’s plan moving forward. He vowed there would be a “surge of activity” in the coming weeks and months to correct the problems.
Murray was one of the senators pressing McDonough that day, inquiring about patient safety, staff support, and how the VA will prevent issues at Mann-Grandstaff and other VA medical centers. Murray organized the oversight of the system’s rollout at the Mann-Grandstaff facility for more than a year. She wrote a letter to previous VA leaders expressing her concern regarding reports of staffing and facility issues and how it could impact the system rollout.
The VA was set to launch its electronic health record system on March 5 at the VA Central Ohio Health Care System in Columbus, but VA leaders pushed back the rollout to April 30. The agency said a “significant number of the workforce,” approximately 209 people, were unable to work due to positive cases of the coronavirus. That number doubled during the week of Jan. 10, the VA said. Columbus was expected to be the second VA site to transition to the new system.
Despite the delayed rollout in Ohio, the VA still plans for the system to deploy at a third site in Walla Walla on March 26. However, the agency is reviewing coronavirus cases there before moving forward.
The outage will not delay the system rollout at the other facilities, the VA said.
Murray said she met with Walla Walla hospital leaders last week for an update on the facility’s readiness for the rollout.
“If their ability to deliver the high-quality care our veterans deserve becomes uncertain at any point — including up until the day before launch — the rollout should be delayed,” Murray said. “I will continue to hold Cerner and VA accountable to the commitments they have made to me both privately and publicly to get this right.”
The VA said it provided Murray and McMorris Rodgers information on the Mann-Grandstaff incident and the steps it took with Cerner to set up corrective measures to resolve the technical issues.
“VA is confident the technical issues resulting in this outage have been resolved and is moving forward with implementing the [electronic health record system] at other facilities,” Paige said. “Recognizing that system outages, though rare, can occur at facilities across the country, VA has established standard procedures for staff to follow that limit the impact on patient care.”
The VA will next launch the system at Roseburg and White City in Oregon on June 11, followed by Boise, Idaho on June 25, and Anchorage, Alaska, on July 16. Other VA facilities in the Puget Sound region are expected to launch the system on Aug. 27.
