A blind employee has filed a federal lawsuit against the Department of Veterans Affairs claiming discrimination over the VA’s new $10 billion electronic health records system. The employee claims the electronic health records system cannot be accessed and used by people with visual impairments. (U.S. Air Force)
WASHINGTON — A blind employee with the Department of Veterans Affairs has filed a discrimination lawsuit against the agency claiming its new $10 billion electronic health records system cannot be used by clinicians who are visually impaired.
Laurette Santos, a VA social worker for 10 years, filed the complaint last month in U.S. District Court for the District of Columbia claiming the VA failed to provide the digital tools that she needs to perform her job despite repeated complaints that she can no longer carry out essential duties independently.
Santos’ job at a VA field office in White City, Ore., is to coordinate services for visually impaired veterans and service members, according to the lawsuit.
“Ms. Santos’s once fulfilling career counseling former service members — including many with disabilities — has transformed into a daily struggle. This lawsuit seeks redress for the injuries she sustained as a result of the VA’s unlawful treatment,” according to the lawsuit.
The VA has 90 days to respond to the lawsuit, which was filed in federal court on June 17.
The VA will not comment on pending litigation, said Terrence Hayes, the VA press secretary.
The lawsuit is seeking to stop the systemwide implementation of the electronic health records system, which has been installed at only six health care sites, until changes are made to enable people who are blind and visually impaired to use it, said Eve Hill, an attorney representing Santos.
The VA has failed to provide “reasonable accommodations and accessible technology” to allow Santos to independently perform her job as a blind individual, nor has the VA offered a “workable solution” or timeline for fixing the problem, Hill said.
Santos is seeking unspecified punitive and compensatory damages, Hill said.
The electronic medical records management system does not provide a screen-reader application that converts text to Braille or synthesized spoken word despite repeated requests by Santos and the National Federation of the Blind, an advocacy organization, the lawsuit said.
Screen-reader applications enable blind employees to use online applications and have meaningful employment in a range of professions and industries, according to the lawsuit.
The VA has spent more than $10 billion to install the electronic health records system since acquiring it in 2018 from the Cerner Corp.
In June, the electronic health records system was installed at the Captain James A. Lovell Federal Health Care Center, a joint health care facility used by the VA and Defense Department in North Chicago, Ill.
The VA also has installed the system at the Spokane VA Health Care System and the VA Walla Walla Health Care, both in Washington state, the Roseburg VA Health Care System in Oregon, VA Southern Oregon Health Care, and the VA Central Ohio Health Care System.
“The VA has failed to remedy the accessibility barriers or to accommodate Ms. Santos” after six years, the lawsuit claims.
Hill said she does not know the level of online access that veterans have to their digital medical records via the electronic system or whether blind and visually impaired patients face similar challenges.
Section 508 of the Rehabilitation Act states federal agencies must make information technology and data accessible to everyone, regardless of disability.
The National Federation for the Blind, which raised concerns about the Cerner system in a letter to the VA prior to its purchase, emphasized the importance of providing blind and visually impaired employees the digital tools that they need to access the new system, as federal law requires.
“We are supporting this litigation not only to help an outstanding blind employee of a critical agency, but also to serve notice to other agencies throughout the federal government that continued willful failure to comply must come to an end and that blind Americans will not stop fighting until it does,” Mark Riccobono, president of the National Federation of the Blind, said after the lawsuit was filed.
The lawsuit seeks a permanent injunction to prevent the VA from using the system at locations where it is already employed or installing it at more hospitals and clinics until it provides accessibility to blind and visually impaired users.
The complaint describes as “disastrous” the consequences that the lack of a screen reader and other adaptative technology has had on Santos and her performance as a VA clinician.
The new technology requires users to read text on a monitor and use a mouse, which blind users are unable to do, the lawsuit said. Santos must now delegate to sighted employees many of her job functions. Her inability to perform critical duties puts her clinical license at risk, the lawsuit said.
Her job duties involve conducting needs assessments for veterans who are blind and visually impaired. She also works to assure appropriate health care services and equipment are delivered, according to the lawsuit.
“There are often breaks in the continuity of care veterans receive when Ms. Santos is unable to review notes from clinicians, including referrals for additional care,” the lawsuit said.
With the new records system, Santos is unable to make and track appointments for veterans requiring assistance.
The National Federation of the Blind said it contacted the VA in 2015 as the agency began considering the purchase of an updated electronic health records system.
The advocacy organization urged the VA in a letter to acquire a system that was compatible with screen-access software for people who are visually impaired, according to the lawsuit.
“The National Federation of the Blind explained that accessibility was an important consideration at the outset of the vendor selection process,” according to the lawsuit.
The nonprofit organization later wrote a letter to the Cerner Corp. after learning the company would be awarded the contract to design the new records system.
The National Federation of the Blind requested Cerner develop technology accessible to people with visual impairments, after previously receiving complaints from blind employees in other workplaces reporting similar problems with Cerner systems, the lawsuit said.
In May 2018, the VA signed a contract with Cerner for the records system with a work order requiring assistive technologies for people with disabilities, including screen-reader applications, screen magnifiers and speech-recognition software, according to the lawsuit.
But the VA failed to consult with VA auditors to ensure the technology, online training and websites under development would be accessible to employees with disabilities, the lawsuit said.
The VA continued to disregard Cerner’s accessibility issues as the system was implemented at VA field offices, the lawsuit said.
Between November 2020 and November 2021, VA auditors reviewed the new system and confirmed it was inaccessible to users who are visually impaired, the lawsuit said.
“When the VA chose its new electronic health record system, it was well aware of the need to meet accessibility requirements,” according to the lawsuit.
Oracle Health acquired Cerner in 2022.
The VA and its vendor have promised to remedy the problem but have yet to provide a workable solution or a timeline for achieving it,” according to the lawsuit.
The VA’s response was to instruct Santos to use the old electronic health records system in a limited format, the lawsuit said.
“This response does not allow Ms. Santos to independently perform the essential functions of her job, nor has it allowed her to handle anything close to the workload she previously completed,” the lawsuit said.
