During the senate hearing, committee chair Sen. Jon Tester (D-MT) said, “There’s been damn little accountability. I hope Cerner’s watching this. If they’re not open to making a user-friendly health medical record, they ought to admit it so we can get the money back and start all over.” He told McDonough that the failures were “not all your fault—I don’t know if any of it is your fault.”
“It’s a lot of money you’ve entrusted to us,” McDonough told the committee. The serious problems, he said, were “on us.” He added, “We are taking swift and decisive action to incorporate the management rigor and enterprise jointness required for this program to deliver on its intended purpose: seamless excellence in VA care for veterans. VA’s first implementation of the [project] did not live up to that promise, either for our veterans or for our providers.”
He said he had ordered an overhaul that will include better training for clinical staff, more reliable testing and oversight of Cerner, and a leadership shake-up. He also said he had installed a patient safety team at the Spokane hospital.
Terry Adirim, MD, formerly with the DoD, took over the EHR program in January. In an interview, she said, “[W]e’ve made a substantial number of changes,” such as a new round of training for the hospital’s medical staff. “These deployments are really complex and they’re really hard,” Adirim said, noting that about half of digital medical records programs at private hospitals fail at first. She pointed to the revamped DoD program, which also had its flaws but is running much more smoothly. One of the issues, she said, is that many physicians did not realize that the Cerner system would differ so dramatically from VistA, the system it’s replacing.
The first installment of the rocky rollout left hospital staff confused and worn out. Sen. Patty Murphy (D-WA) said in 2021 that the Spokane staff had filed hundreds of reports of patient safety issues caused by the new system. “Patients are not getting accurate meds. Meds are sent to the wrong address. What used to take a few clicks is now a lot more complicated. Providers are burning out.”
A year later, in a statement, echoing her earlier comments, she said, “We need to put a pause on this rollout right now.”
But Adirim has said the VA is moving ahead with the rollout. The VA has added extra support staff and plans to have physicians from outside the hospital on hand in case things go wrong. According to the Washington Post, Deputy VA Secretary Donald Remy told the OIG that the VA is working to address the outstanding issues and hopes to resolve them by mid-May.
Meanwhile, the beleaguered project ran into another obstacle in early March, when computers went down at Mann-Grandstaff, leading to 20 hours of yet more confusion about medications and surgeries. The VA said the IT system outage also happened at Columbus, Ohio (another of the planned pilot spots). The system was back online the next day, with no known patient safety issues.