VA halts beleaguered Cerner EHR challenge by means of 2021 to attempt to proper the $16B ship

The Division of Veterans Affairs scrapped the rollout schedule for its new medical data system for no less than six months to overtake coaching and repair governance and administration issues, recognizing elementary flaws within the work to date.

The deliberate six-month pause comes after a 12-week strategic overview ordered by VA Secretary Denis McDonough that checked out issues with the preliminary go-live of the Cerner digital well being file system on the Mann-Grandstaff VA hospital in October 2020.

Carolyn Clancy, M.D., an assistant undersecretary for well being at VA, informed lawmakers throughout a Home listening to final week that by the tip of the calendar 12 months a brand new deployment schedule might be in place – one that’s totally different from the preliminary geographic rollout schedule that started within the Pacific Northwest. 

Mann-Grandstaff VA Medical Heart in Spokane, Washington was the primary website to go reside with a brand new Cerner EHR system in October.

VA plans to overview the IT and bodily infrastructure at each facility within the VA system and “subsequently deploy based mostly on which internet sites are within the best state of readiness,” she testified.

The VA additionally plans to have an unbiased estimate of your complete lifecycle price of the 10-year challenge, which was initially pegged at $16 billion however has jumped to $21 billion based mostly on underestimated infrastructure prices.

“We’re ranging from scratch,” Clancy stated about the associated fee estimate. The full lifecycle price estimate will take near a 12 months, she stated.

RELATED: VA underestimated infrastructure prices that might increase EHR price ticket by as much as $5B: OIG

It marks the most recent in a sequence of serious setbacks for the VA’s troubled $16 billion know-how challenge that is been tormented by delays, management turnover, and infrastructure issues because it kicked off in 2018.

Members of the Subcommittee on Expertise Modernization stated they supported the choice to hit the pause button on the challenge, citing considerations over potential affected person security dangers, inadequate coaching for suppliers and up to date experiences from the VA’s Workplace of the Inspector Normal highlighting infrastructure points and insufficient price estimates.

Current OIG experiences referred to as out issues with know-how coaching and growing old infrastructure at VA amenities throughout the EHR deployment and some lawmakers proceed to have considerations about using Cerner’s software program for the brand new medical data system.

“Till the Cerner system is proven to be completely secure in Spokane and totally practical, it should not be rolled out wherever else,” stated Rating Member Matt Rosendale, R-MT, throughout the listening to. “I am not fascinated about shoveling extra money right into a flawed program simply to maintain paychecks flowing.”

The VA’s 12-week strategic overview of the EHR implementation at Mann-Grandstaff checked out points round affected person security, productiveness price, schedule and efficiency. The affected person security considerations uncovered throughout the strategic overview didn’t lead to bodily hurt to sufferers, Clancy stated. Nonetheless, stakeholders lack readability on the broader definition, nature and variety of affected person questions of safety associated to the brand new EHR implementation, she stated.

RELATED: First VA medical heart (lastly) goes reside on Cerner EHR as a part of $16B challenge

Throughout a listening to earlier this month, Veterans Affairs Secretary Denis McDonough informed lawmakers {that a} three-month inside overview of the digital well being data system discovered so many structural issues that he can’t proceed to deploy it at different hospitals till VA leaders are assured of success, The Washington Put up reported.

He cited critical “governance and administration challenges” which have dogged it from the outset, saying, “that’s on us,” as reported by The Washington Put up.

However McDonough additionally informed lawmakers that he was not contemplating abandoning the $16-billion challenge to make use of the Cerner Millennium data platform. The VA Secretary has ordered an overhaul that can embody higher coaching for medical employees, extra dependable testing and oversight of Kansas Metropolis-based Cerner and a management shake-up, the report stated.

Regardless of the VA’s assurance, Rosendale and different lawmakers proceed to have considerations in regards to the large challenge.

“We’re going to seek out out the proof is within the efficiency. If the military of crackerjack administration consultants, and tiger groups, and development groups, and the adoption coaches, and the change administration consultants can’t make headway with the scenario in Spokane, the reason being in all probability fairly easy. The software program simply isn’t any good, of us. Both that or it isn’t good for the VA,” he stated throughout final week’s listening to.

Brian Sandager, basic supervisor at Cerner Authorities Providers and a former hospital chief data officer, informed lawmakers that many EHR implementations stall after their preliminary deployment resulting from an absence of clear imaginative and prescient, governance, readability, management and making well timed choices.

RELATED: Lawmakers irked at lack of transparency from VA after Cerner EHR challenge delay

“Success begins from the highest, establishing a transparent governance course of and expectations enable a corporation to stay agile and determine and resolve points. We have now not carried out a ok job articulating to VA finish customers why this transformation is so vital for veterans, the advantages it’s going to obtain for the enterprise and we’ll accomplice with VA to alter this,” he testified.

Sandager stated the COVID-19 pandemic disrupted Cerner’s strategy to utilizing greatest practices for end-user coaching. “We’ll treatment that going ahead. A technique [to improve training] is to verify there’s a holistic end-to-end workflow dialogue with end-users. Customers will take part from design by means of the testing and into the coaching,” he stated.

Previous to and throughout the VA’s strategic overview at Mann-Grandstaff, Cerner labored to resolve many points, together with making almost 800 adjustments to enhance coaching, simplify workflow design and alerts and cut back the time suppliers are spending within the system, he stated. Cerner additionally modified almost 300 opioid prescriptions on Cerner EHR alerts, leading to various remedies for these at increased danger of use issues. 

Cerner additionally has performed over 550 post-go-live coaching lessons to greater than 1,400 customers, amongst these customers are new VA personnel at Mann-Grandstaff, in line with executives.