Throughout a listening to in entrance of the Senate Committee on Veterans Affairs final week, VA Secretary Denis McDonough mentioned a evaluate of the company’s digital well being information modernization effort revealed a number of excellent points that should be resolved.
“EHRM’s mission has at all times been to create a platform that seamlessly delivers the most effective entry and outcomes for our veterinarians and the most effective expertise for our suppliers,” McDonough mentioned.
“The primary VA implementation of the Cerner Millennium … didn’t dwell as much as that promise, not for our veterans or for our suppliers,” he continued.
BECAUSE IT IS IMPORTANT
McDonough described the findings of a 12-week evaluate of the EHRM program initiated after the primary deployment of Cerner’s Millennium platform on the Mann-Grandstaff VA Medical Middle in Spokane, Washington, final October.
He relayed a number of anecdotes about issues at Mann-Grandstaff, together with duplicate prescription ordering incidents and difficulties with Cerner’s assist.
When a health care provider known as customer support, he mentioned, “The particular person on the opposite finish of the road advised him that he had simply began every week earlier.” In different phrases, she had extra expertise utilizing the platform than the one that was supposed to assist her navigate, “he continued.
“The strategic evaluate illuminated a variety of points and affirmed many stakeholder issues,” McDonough mentioned in written testimony offered to the committee. Preliminary issues recognized included:
- Affected person security. Though employees took quick motion on clear points, McDonough mentioned stakeholders lacked readability on the broader definition, nature and variety of affected person questions of safety associated to the brand new EHR implementation.
- Productiveness, with a big decline post-implementation exacerbated by the COVID-19 pandemic.
- Governance and administration. McDonough throughout his testimony famous the remoted nature of the challenge. “Transferring ahead, VA is pursuing unified governance throughout the enterprise that comes with the views of key medical, technical, procurement and monetary leaders, amongst others,” he mentioned in written testimony.
- Price, schedule and efficiency. Not solely had been value estimates decreased by billions of , as outlined in OIG studies, however the challenge’s KPIs weren’t successfully created, maintained, or managed.
- Affected person portal expertise, which McDonough described as “fragmented” for veterans.
- Exams: “Scientific and interdisciplinary workflows weren’t examined previous to ‘go dwell’ in a means that successfully mirrored a real-world surroundings,” McDonough mentioned in written testimony.
- Knowledge, with gaps within the potential to handle knowledge between VA’s legacy VistA EHR and Millennium, together with the Division of Protection, to make sure seamless data trade.
- Change administration and coaching. Workers should perceive and have efficient assist to finish the important thing features of their roles throughout the new system.
McDonough mentioned the VA is taking particular steps to deal with every of those points.
Total, he mentioned, the VA is “reimagining our strategy to modernizing digital medical information.”
“Previous to deployment to further websites, VA will even enhance our governance and organizational construction to be extra responsive and efficient, in addition to spend money on coaching and alter administration capabilities to raised put together the workforce for the Cerner answer to be deployed. at their particular person places, “he mentioned.
Members of the VA committee expressed their displeasure on the launch to this point.
“Most individuals would use the phrases ‘alarming’ or one thing a lot worse,” mentioned President and Senator Jon Tester, Democrat of Montana, in opening remarks.
“Frankly, in my view, I’m fed up with the quantity of taxpayer that we’re spending on this program with none demonstrated profit to VA veterans or medical personnel,” he continued.
“I share your exasperation on this concern,” mentioned Sen. Jerry Moran, Republican of Kansas, a senior member.
“It’s infuriating as a result of the potential advantages that may be derived from this effort are great,” he added.
“I suppose it’s probably a value saving, however an important factor is the flexibility of the Division of Veterans Affairs to look after veterans.”
THE BIGGEST TREND
VA’s digital well being information modernization challenge has confronted quite a few obstacles which have acquired a lot publicity.
After the preliminary launch at Mann-Grandstaff, McDonough mentioned the company would halt efforts to advance a second website till a evaluate was carried out. Quite a few studies from the OIG adopted, which Moran characterised on the listening to as “damning.”
Though McDonough mentioned the company would keep the course with Cerner, it’s not but clear what the way forward for the challenge appears to be like like.
IN THE REGISTRY
“You will notice us proceed to extend exercise within the weeks and months forward, with an intense deal with the veteran expertise, affected person security and worker engagement,” McDonough mentioned in written testimony.
“The profitable deployment of a contemporary EHR is crucial to delivering world-class well being care and advantages for all times for veterans, in addition to setting the usual for US well being care on a big scale – and we are going to. positive, “he mentioned.
Kat Jercich is Senior Editor for Healthcare IT Information.
Healthcare IT Information is printed by HIMSS Media.