VA EHR has seen 826 major performance incidents since launch

The new Department of Veterans Affairs EHR has seen over 800 major performance incidents since its deployment, according to a VA Office of Inspector General (OIG) report.

In May 2018, VA awarded a 10-year EHR contract to health IT vendor Cerner (now Oracle Health). Since system deployment began in October 2020, end-users have experienced hundreds of major performance incidents at the five medical centers where VA initially implemented the system.

A performance incident is defined as major when it causes severe system degradation, leads to an outage of services required for key operations or impacts patient care and requires a response beyond routine incident management.

In response to these issues, VA halted all planned EHR deployments in July 2022, except for implementation at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, on March 9, 2024.

However, major performance incidents have continued as recently as March 2024.

The OIG report found that VA and Oracle Health did not have adequate controls in place to prevent system changes from causing major incidents. Further, VA and Oracle Health did not have adequate controls to respond to major incidents and mitigate their impact when they did occur.

The OIG audit found that 360 major performance incidents happened between Oct. 24, 2020, and Aug. 31, 2022.

For instance, on March 3, 2022, the EHR was disrupted for 27 hours and seven minutes at the Mann-Grandstaff VA Medical Center in Spokane, Washington, due to a system change that halted operations. The medical center director noted that many patients needed to reschedule their appointments.

"Although other causes the team identified led to some of the issues identified in this report, ultimately the inadequate controls for handling major incidents originated in how the May 2018 contract was written," the OIG authors explained.

In May 2023, VA updated its contract with Oracle Health to strengthen requirements for addressing major incidents. However, system issues have continued.

From system go-live on Oct. 24, 2020 through March 31, 2024, there were 826 major performance incidents, including outages, performance degradations and incomplete functionality.

The OIG report underscored that although VA updated its EHR contract in May 2023, VA should consider additional controls to prevent further incidents from occurring and strengthen the department and contractor's response to them.

"If actions are not taken to improve EHR operations, major performance incidents will continue to occur, leading to further delays in EHR system implementation while putting patient safety at risk," the report authors wrote.

‍Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.