Cerner Falls Short of VA EHR System 'Uptime' Obligation

Cerner has not kept the EHR system at Spokane’s VA hospital online consistently enough to meet an obligation in its $10 billion contract with the Department of Veterans Affairs (VA), according to reporting from The Spokesman-Review.

As part of its VA contract, the EHR vendor must meet a minimum level of “uptime,” or time during which the health IT is fully available to users.

Terry Adirim, program executive director of the VA EHR Modernization (EHRM) Integration Office, said in response to questions from The Spokesman-Review that Cerner will give VA a credit in exchange for falling short of the target. However, she did not specify how much Cerner will provide a discount.

Adirim said that the system was down for a total of 30 hours and 33 minutes from its launch in 2020 until April 20, 2022. VA previously confirmed the EHR was partially or entirely unusable 50 times during that same period, including nine “unplanned outages” and 42 “unplanned degradations.”

The downtime total does not include all the reliability problems veterans and VA employees have faced for over a year and a half, nor do the reported outages or degradations, according to definitions of both terms Adirim provided.

She explained that an outage is an “unscheduled event where a clinician is unable to use the electronic health record because the entire system is down.”

A degradation is “when all systems and applications are available, but all clinicians experience a similar issue, including the system running slower than normal,” she said.

A third category which involves “system errors, latency, and application incomplete functionality” while “portions of it were still working,” was not included in the total incidents.

Adirim said VA tracks those issues through “trouble tickets” users can submit to report problems.

Neither figure includes incidents on April 25 and 26 when the system was not fully accessible for several more hours, the news outlet reported.

She noted that the April 25 incident, which occurred while Donald Remy, VA deputy secretary, visited Mann-Grandstaff, was initially considered an outage but later reclassified as “incomplete functionality and performance degradation” that lasted about two hours.

The following day, while Remy visited the Walla Walla hospital and Adirim testified before a House subcommittee, the EHR went down completely.

She told the news outlet that Cerner is analyzing the root causes of the problems on April 25 and 26.

Neither of those instances are connected to a March 3 incident when veterans’ records were “jumbled,” leaving Mann-Grandstaff unable to admit new patients, Adirim said.

In a statement, Cerner said it “understands and acknowledges” VA’s concerns with the outages and degradation, and it addresses those concerns “quickly and aggressively.”

According to the statement, the company has “proactively initiated a technical review” and remains committed to providing veterans and VA employees with “an effective, reliable, and safe” system.

Calling any downtime or service disruption “unacceptable,” the vendor said it is taking proactive steps to address the issues, including assessing its internal processes and employee training.