VA Medical Center Shrinks Workforce to Address EHRM Budget Shortfalls

The rising budget associated with the Department of Veterans Affairs’ (VA) Electronic Health Record Modernization (EHRM) project has led to workforce cuts at Mann-Grandstaff VA Medical Center, according to reporting from The Spokesman-Review.

Since the start of its implementation, the Oracle Cerner EHR system has been plagued by prescription errors, incorrect patient information, and delays in follow-up care caused by lost referrals.

An investigation at current implementation sites revealed nearly 500 major incidents and at least 45 days of downtime have been recorded with the Oracle Cerner EHR system since the system go-live in 2020.

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

Following the several arising, the VA hired extra employees at the Mann-Grandstaff facilities to balance the subsequent productivity decrease after the Oracle Cerner implementation.

The Spokane hospital increased its staffing level by about 20 percent between October 2018 and September 2022, mainly to mitigate the impact of the Oracle Cerner system, Terrence Hayes, VA press secretary, said in a press release.

VA press secretary also said the system had increased the cost of care provided in VA facilities that have implemented the Oracle Cerner EHR.

He confirmed that slowdowns caused by the EHR had reduced the facilities’ ability to treat veterans and forced the department to send more patients to outside hospitals, resulting in added costs.

“The medical centers in our districts should not have to choose between staffing up to continue safely caring for veterans and blowing a hole in their budgets, forcing painful cuts in the future,” several legislators, including Congresswoman Cathy McMorris Rodgers (WA-05), wrote to VA deputy secretary Donald Remy.

“Whatever is ultimately decided about the fate of the program, our medical centers cannot be left behind,” the lawmakers continued. “They have been forced onto a deeply flawed system, and they are struggling to address the needs of the veterans in our communities.”

However, a budget crunch worsened by the increased payroll and reduced revenue due to the new system led regional VA leaders to Mann-Grandstaff to shrink its staff by eliminating positions as they become vacant.

The extra time it takes to complete tasks in the Oracle Cerner system has impacted the number of patients that can receive care by VA physicians. These current care access issues, coupled with staffing cuts, will also worsen the problem, VA employees mentioned.

“The result is more veterans being referred to private clinics and hospitals in the area, which are struggling with their own capacity problems due to the pandemic and pervasive staffing shortages throughout the US health care sector,” according to reporting from The Spokesman-Review

The head of Mann-Grandstaff’s Office of Community Care mentioned the number of “priority referrals” asking for urgent appointments at private hospitals had increased by 433 percent since the previous fiscal year, producing an excessively large backlog that is still processing non-urgent referrals from September.

“The community is saturated,” the office’s chief wrote, referring to private clinics and hospitals, in an attached document, which showed the excessive wait times for specialty care outside the VA.