VA Official Says EHR Budget Shortfalls Will Not Impact Spokane Service

After the Department of Veterans Affairs (VA) admitted a new EHR system has upended the budget of Spokane’s VA hospital, a top official said the issue would not result in service cuts at Mann-Grandstaff VA Medical Center or other facilities, according to reporting from The Spokesman-Review.

Shereef Elnahal, VA undersecretary for health, told reporters on Wednesday that he was looking closely at the new EHR system’s impact on the finances of the Inland Northwest hospitals and clinics.

“We will make sure that those facilities get the resources they need for the vets that they’re seeing,” said Elnahal.

Terrence Hayes, VA press secretary, said the system has increased the cost of care provided in VA facilities that have adopted it in written responses to questions from The Spokesman-Review on Monday.

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

Hayes said the Veterans Health Administration (VHA) is working with the EHR vendor, Oracle Cerner, to resolve problems with its system.

Additionally, Hayes said that the EHR is “not equipped” to correctly bill patients and insurance companies, “causing a significant reduction in overall collections” at the four Northwest VA medical centers where the VA has deployed the system.

The only VA hospital outside of the Northwest using the system is in Columbus, Ohio, where Elnahal visited earlier this month. On Wednesday, he said employees there told him of “increased stress” and “difficulty with the system as it is currently configured.”

“The system should ultimately be something that enables better care and be intuitive, and we’re not there yet with this system,” Elnahal said. “It has to improve.”

Hayes said the VHA has given additional funding to the regional division that covers Washington, Oregon, Alaska, and parts of Idaho and Montana to ensure that the regions are funded as required for “lost productivity and the associated budget shortfalls that have been identified to VHA’s Office of Finance.”

Hayes noted that the VA has not directed any regional facility to reduce its staffing level because of budget problems.

In July, Congresswoman Cathy McMorris Rodgers (WA-05) and several other legislators sent a letter to Donald Remy, VA deputy secretary, asking that the VA create a fund for additional staffing at hospitals and clinics using the new EHR.

“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,” they wrote.

“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.”

Hayes explained that the VA’s budget does not currently include the “staff augmentation fund” requested by the lawmakers. However, the office in charge of rolling out the new system is collaborating with other parts of the VA “to provide additional resources such as more training, at-the-elbow support, and virtual clinical resources as necessary for successful deployment.”

Congress has already appropriated money for additional staff for “deployment and implementation activities,” Hayes noted. That approach assumes a hospital will serve fewer patients while employees learn to use a new EHR system, something Elnahal said is normal.

“However, it shouldn’t decrease permanently,” he emphasized. “There should be a restoration of productivity over time.”

In March, Remy told The Spokesman-Review he expected productivity at the VA hospital in Walla Walla to return to normal within three months of go-live. Six months later, Hayes said the hospital “has not returned to pre-deployment productivity.”

At that same time, Remy said productivity at Mann-Grandstaff had already returned to normal, pre-Cerner levels.

However, on Monday, Hayes said productivity “is increasing month-over-month and returning to pre-deployment levels.”