ID Legislators Call for Resolution of VA EHR Patient Safety Concerns

The Department of Veterans Affairs (VA) has continued to rollout a Cerner EHR system despite patient safety concerns, including a proposed June 25 implementation at the Boise VA Medical Center (VAMC), according to The Idaho Congressional Delegation.

“We owe it to Idaho veterans to ensure they get proper access to the services they deserve,” Senator Mike Crapo, Senator Jim Risch, Representative Mike Simpson, and Representative Russ Fulcher wrote in a column. “These include ensuring systems designed to streamline veterans services do not prevent them from getting the medicines and other resources they need.”

A March VA Office of the Inspector General (OIG) report detailed care coordination issues following the EHR implementation at the Mann-Grandstaff VA Medical Center in Spokane, Washington.

The system issues included limited access to suicide prevention and assessment tools, EHR-based delays in scheduling PCP appointments, and lab orders “disappearing” before reaching the facility laboratory. Despite knowledge of these problems, the VA has continued to rollout the new EHR system at other VAMCs.

Since the March OIG report, the legislators said they “read with dismay” a report of a veteran being hospitalized with heart failure after the EHR contributed to a vital medication not being renewed. 

The lawmakers raised concerns detailed in the March OIG report and a prior July 2021 OIG report in an April letter to Denis McDonough, VA secretary. 

“Alarmingly, the July 2021 OIG report states after more than two months of the EHR use at the Mann-Grandstaff VAMC, 95 percent of VAMC staff reported they were unable to use at least one of the four core functions of the new health records system,” the legislators wrote.

The lawmakers asked McDonough a series of questions about the EHR rollout in the letter, including: 

• Why has the VA continued the system rollout despite unresolved issues?
• Has VA considered delaying implementing the system at the Boise VAMC until the problems are addressed?
• What training will the VA provide to ensure adequate understanding of the new system?
• What support will be in place to ensure the Boise VAMC continues to have the necessary resources to provide timely care to veterans?
• What steps has the VA taken to ensure veterans care is not further impacted by the system rollout?

“Medicine dosing and navigating federal programs can be complicated for aging veterans and their families,” the legislators wrote. “Innovations that help ease access to quality care are great when they can deliver. However, when deficiencies surface, such as those with the EHR system, they must be addressed quickly.”

“While it is our expectation that VA EHR modernization ultimately improves veterans’ access to care, the rollout of the EHR system has thus far fallen short—resulting in confusion, frustration and alarming situations for many veterans and their medical providers,” the lawmakers concluded. “We will continue to press for timely resolution of these issues on behalf of Idaho veterans and their families.”