VA EHR Modernization Project Receives Internal Backlash

Leaders from the Department of Veterans Affairs (VA) EHR Modernization (EHRM) project are facing scrutiny from the department’s unions and internal groups, according to a POLITICO report.

These issues range from the system’s patient data sharing capabilities, to questions surrounding leadership, to a lack of a warning regarding a recent EHRM deployment.

While the initial EHRM implementation at Mann-Grandstaff VA Medical Center in Spokane, WA was considered an early success, reviews and interviews from those inside the deployment showed real concerns over the project design and the VA’s oversight.

The new Cerner patient portal draws concern because more than 2,000 veterans have already created accounts. John Windom, executive director of VA EHRM Office, told POLITICO, VA is reviewing the portal. Members of Congress and veterans service organizations said the new solution would confuse VA patients due to a lack of familiarity.

VA leaders also expressed concern over the system’s patient data sharing capabilities, highlighted by its “data syndication.” VA leaders told POLITICO the assessment should have occurred years ago.

Furthermore, an outside consultant said EHRM leadership was incapable of receiving feedback from VA employees and called those leaders “simultaneously bloated.”

“The information in this internal review confirms what many of my colleagues and I have been saying for months: VA must engage with medical staff on the ground and other key stakeholders as they deploy this multi-billion dollar, multi-year initiative,” Senator Jon Tester (D-MT), ranking member of the Senate VA Committee, said to POLITICO.

Following criticism, Windom said VA leaders are implementing the outside recommendations and are optimistic about the overall project.

“There are a lot of moving parts,” Windom explained. “I spent 33 years in the DoD; I did not know what moving parts were until I got to VA.”

Along with Mann-Grandstaff VA Medical Center, the Cerner-led project launched at the medical center’s four associated community-based outpatient clinics and the West Consolidated Patient Account Center in Las Vegas, NV. Because it is an account center, the office received new billing software during the EHRM rollout.

However, employees at the center said the deployment missed the mark.

“It’s not working properly. There’s a lot of errors in it,” William Wetmore, an executive vice president of AFGE’s National VA Council, said in a statement. “The bills are erroneous.”

Wetmore said if a bill from an outside provider comes back to the office, VA employees might not know if the bill is correct.

“It’s probably something we should litigate, but I’m not an ambulance chaser,” Wetmore continued.

Windom said VA established an after-action group to collect feedback from its EHR users to aid future EHRM deployments. He also said leaders engaged the union from day one.

“It’s important we don’t compromise the care we’re giving to veterans,” Windom said.

With the Mann-Grandstaff launch behind them, VA will exit the Pacific Northwest region for implementations at smaller Midwest medical facilities, called EHR 1.1. The second round of deployments should launch in spring 2021.

In late November, VA announced it was integrating prescription drug monitoring program (PDMP) data into the EHR to ensure safer prescribing practices across its health system.

The EHR tool aims to improve prescribing practices, target treatment to at-risk patients, and mitigate the risk of potential abuse or fraud by patients who obtain prescriptions from multiple providers. Providers can review the data before prescribing opioids to intervene if there are signs of misuse or abuse.

As of now, two VHA Medical Centers, or more than 500 providers, have this tool integrated into the EHR. In the future, VHA plans to conduct a national launch to include nearly 20,000 providers.