MHS GENESIS Update Sparks EHR Slowdown Across VA Medical Facilities

A system update to the Department of Defense (DOD) MHS GENESIS platform caused an EHR slowdown at multiple Department of Veterans Affairs (VA) medical facilities,according to reporting from The Spokesman-Review.

On Tuesday, modifications made by the DOD to its EHR system, which shares a database with the VA, “had the unintended consequence of interrupting services that provide connectivity to the network,” Terrence Hayes, VA press secretary, confirmed in a statement.

During the slowdown, Oracle Cerner EHR users experienced “long intervals” for the next screen each time users clicked a button in the system.

The challenges increased clinician stress; prior to the performance degradation, EHR users were already struggling with EHR challenges that limited patient care access.

In an internal chat, Mann-Grandstaff VA Medical Center employees voiced frustration with the slowdown. Specifically, some mentioned working greater hours in order to compensate for EHR system lags and document patient treatment in the system.

Alongside VA medical facilities, over 50 percent of all Military Health System providers and nearly every medical facility using the system were affected.

By Tuesday afternoon, several “configuration changes” were made to fix the slowdown. Additionally, Hayes stated that the VA would “continue to monitor the system and user feedback to confirm the lag is fixed.

The new system's rollout to unite military and veteran health records has featured various setbacks.

A 2022 Freedom of Information Act (FOIA) request revealed that the VA had experienced nearly 500 major incidents and at least 45 days of downtime since the system go-live in 2020.

The EHR system had 930 hours of “incomplete functionality” and 40 hours of “outage” between Sept. 8, 2020, and June 10, 2022.

In almost half of the incidents, the root cause was not apparent to the VA, according to the reported data.

“The bottom line is that my confidence in the EHR is badly shaken,” Denis McDonough, VA secretary, said in a statement provided to FedScoop. “Regardless of whether an outage in the system lasts for one minute or one hour or one day, any outage or delay is unacceptable for the Veterans we serve and our VA healthcare providers who serve them.”

VA medical facilities such as the Mann-Grandstaff VA Medical Center have seen 42 “unplanned degradations” and eight “unplanned outages” between its launch and April 20, 2022.

Officials said they would continue to work with Oracle Cerner to resolve EHR performance bugs in the upcoming months, especially issues with patient safety implications.

“Right now, the Oracle Cerner electronic health record system is not delivering for Veterans or VA health care providers – and we are holding Oracle Cerner and ourselves accountable to get this right,” Donald Remy, deputy secretary of Veterans Affairs, said in November a public statement.

“We are delaying all future deployments of the new EHR while we fully assess performance and address every concern,” he added. “Veterans and clinicians deserve a seamless, modernized health record system, and we will not rest until they get it.”