An electronic health record system being piloted at Spokane’s VA hospital and other sites in the Inland Northwest has been partly or completely unusable at least 50 times since its launch in 2020, the Department of Veterans Affairs confirmed.
The computer system, which health care workers rely on to track patient information and coordinate care, saw a total of 42 “unplanned degradations” and eight “unplanned outages” between its launch in 2020 and April 20, 2022, VA spokesman Randal Noller said in an emailed response to questions from The Spokesman-Review. Two more outages occurred April 25 and 26, VA officials told a congressional panel at the time, for a total of 52 incidents.
The system, which launched at Spokane’s Mann-Grandstaff VA Medical Center in October 2020, is being developed under a $10 billion contract awarded to Cerner Corporation in 2018, without the competitive bidding process that applies to most federal contracts of that size. The VA Office of Inspector General has estimated the planned 10-year effort, which is behind schedule, will cost as much as $21 billion and another $2 billion for each additional year it takes to finish.
In the email, Noller emphasized that most of the incidents were not “large-scale outages,” such as one in early April that affected VA as well as the Department of Defense and the Coast Guard, which also use the Cerner system. Many of the “degradations of service,” he said, affected only some of the users at Mann-Grandstaff and its affiliated clinics in Spokane, Coeur d’Alene, Sandpoint, Wenatchee and Libby, Montana.
After multiple delays prompted by problems in the Inland Northwest that threatened patient safety and left health care workers exhausted and demoralized, VA launched the Cerner system at facilities in Walla Walla on March 26 and in Columbus, Ohio, on April 30. The rest of the nation’s more than 1,200 VA facilities continue to use an older system, known as VistA, which remains popular among health care providers.
“No matter the type or size of incident, VA and Cerner employ an extensive incident management protocol to ensure users can continue to provide quick, safe and effective care,” Noller said in the email.
When the system goes down, the affected VA employees are forced to use “downtime procedures,” which involve recording all information with pen and paper and entering it into the system once it is restored.
The department had acknowledged several outages in recent months after they were reported by The Spokesman-Review and other news outlets, but had not previously revealed the total number of times the system has gone down. VA did not answer a question about the total amount of downtime that has occurred and did not immediately respond to follow-up questions.
In an exchange with Sen. Patty Murray, D-Wash., in a Senate Appropriations subcommittee hearing Wednesday, VA Secretary Denis McDonough said he was frustrated by the six outages that had occurred since March 3. But when Murray asked the VA chief to commit that the system would not be brought to any other sites in Washington until the problems are fixed, he committed only to “make every decision based on the experience of the learning to date.”
In a House VA Committee hearing April 28, McDonough told Rep. Matt Rosendale, R-Mont., he would not allow VA to continue rolling out the Cerner system “if I ever have any reason to think that this is creating risk for our patients.”
In the same exchange with Rosendale, McDonough said he had closely read an April 24 Spokesman-Review story about a veteran who was hospitalized with heart failure for five days in March after the Cerner system played a role in a vital medication being mistakenly stopped. A Spokesman-Review investigation in December found Mann-Grandstaff employees fear the system represents a danger to veterans.
In an April 26 hearing, Rep. Frank Mrvan of Indiana, the Democratic chair of the House subcommittee charged with oversight of the Cerner rollout, said the system should not be deployed at larger, more complex facilities like the VA medical centers in Seattle or Portland until problems are resolved. In the same hearing, Don Pirraglia — who until recently served as the top Veterans Health Administration official working on the Cerner rollout — said he had made that same recommendation, but McDonough has not announced any change to the deployment schedule.
The Cerner system is next set to launch in Roseburg and White City, Oregon, on June 11; Boise on June 25; Anchorage, Alaska, on July 16; Seattle and other Puget Sound facilities on Aug. 27; three sites in Michigan on Oct. 8; and Portland on Nov. 5.
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