GAO Calls on VA to Address EHRM Health Data Management Issues

The Department of Veterans Affairs (VA) needs to address health data management challenges for its EHR modernization (EHRM) project, according to a Government Accountability Office (GAO) report that raises patient safety concerns related to data quality.

VA’s planned data management activities for its EHR implementation included migrating legacy data to the new Cerner system. Consistent with its plans, VA migrated selected data to the new EHR platform in October 2020 prior to the initial system deployment.

While VA conducted testing to help ensure migrated data were accurate and matched expected results, VA’s analyses and GAO’s report indicate that clinicians experienced challenges with the quality of migrated data.

Clinicians reported challenges with data accessibility, accuracy, and appropriateness, in particular.

For instance, VA issued a report after the initial deployment that identified patient safety risks in the new system related to incomplete data migration.

GAO officials noted that the challenges occurred, in part, because VA did not establish performance measures and goals for migrated data quality.

“Until VA uses such measures and goals to better ensure the quality of migrated data, the department could deploy a new EHR system that does not meet clinicians’ needs and poses risks to the continuity of patient care,” the report authors wrote.

The second step in VA’s planned activities for EHRM health data management included preserving existing reporting capabilities and delivering new ones.

The department engaged stakeholders and incorporated their requirements into plans for reporting continuity. However, VA did not use a key tool known as a stakeholder register to identify and engage all key stakeholders.

“Consequently, certain relevant stakeholders were overlooked,” the report authors wrote. “By using a stakeholder register, the department would be better positioned to meet their continuity of reporting needs.”

GAO gave two recommendations to VA to improve its data management strategy.

First, GAO called for VA to establish and use performance measures to ensure the quality of migrated data.

GAO also suggested VA use a stakeholder register to identify and engage all relevant EHRM stakeholders to meet their reporting needs. VA concurred with GAO’s recommendations, the report authors noted.