The VA is attempting to resume the launch of its EHR Modernization program in the fall after facing interoperability issues and a need for further resources.
Following its third delay since November 2019, the Department of Veterans Affairs (VA) is planning to resume the launch of its Electronic Health Record Modernization (EHRM) program in October 2020, according to POLITICO.
This comes even as EHRM interoperability is not functioning as intended, and a more extensive EHR version needed for larger health systems remains incomplete, according to POLITICO’s congressional sources. As a result, this may require further delays and a need for further resources.
In addition, a lack of key information from several future sites is impacting the department’s estimates for the cost of physical upgrades.
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While a VA spokesperson did not agree with the assessment, the spokesperson said the organization was “in the process of doing site surveys related to cabling and other network equipment.”
“At this time, the majority of the sites have had initial assessments for network infrastructure, providing a more complete picture of the required components, including cabling that needs upgrading for the new EHR,” the spokesperson said in a statement to POLITICO.
Before the coronavirus outbreak, the Cerner-led EHR project was initially set to launch by the end of 2019, before being pushed to late March 2020.
Then, the VA announced a delay to July 2020, due to integration issues.
These reports come amid previous hiccups in the EHRM development.
A late-April Office of Inspector General (OIG) report, centered around the EHRM system, found a variety of potential patient safety issues and EHR capability problems that could occur when the new system eventually launches.
The OIG investigation was triggered when a VA spokesperson stated that six weeks prior to the initial March 28 launch date, the implementation was only 75 to 80 percent complete at the Mann-Grandstaff VA Medical Center in Spokane, WA.
While the VA said it is aiming to provide the best patient care as possible by way of the 2018 VA MISSION Act, OIG said the new EHR system might not be able to live up to those goals. OIG noted a lack of EHR system stability, a need to use workarounds, poor EHR usability, and a lack of proper EHR training.
In the report, OIG found VA facility leaders needed guidance about how to address care risks, and facility leaders at Mann-Grandstaff had only hired 48 of the 108 planned additional staff for the EHR expansion.
“Facility leaders estimated that the new EHR implementation would result in a 30 percent decline in access to care, which might last for 12 to 24 months after going live,” OIG wrote in the report. “This decline will impose access to care risks that require mitigation strategies.”
OIG also found that VA attempted to launch the EHRM with an incomplete set of system capabilities, which could result in a significant patient safety risk. Although OIG was unable to identify every patient safety risk, the workarounds for the electronic prescription refill process alone was a considerable concern.
OIG gave VA leaders a list of recommendations that they said need to be implemented to enhance patient safety before the next launch date.
According to POLITICO, VA leaders have acknowledged the issues. However, the agency must also contend with additional issues related to interoperability, patient data exchange, and patient data migration from the old VistA system to the new system.
While one source said the system’s migration effectiveness was a question mark, the VA said it migrated the data over a year ago. However, VA also said it migrated patient demographic information just a week ago.
In an attempt to fix the interoperability issue, VA launched the Veterans Data Integration and Federation Enterprise Platform (VDIF EP) to enhance interoperability and patient data exchange.
This platform aims to create a longitudinal patient record by making veteran patient data interoperable across VA and external EHR systems, which has been a goal of the agency for more than a decade.
However, an anonymous VA doctor told POLITICO her employer still relies on fax machines to exchange patient data, and Linda Ward-Smith, union president of the American Federation of Government Employees’ Las Vegas Local, said a lack of clinician awareness regarding the new platform could be the main issue.
“We still receive a large number of faxes in community care which leads me to believe providers are not aware they can just sign up to have records exchanged electronically,” Ward-Smith said.
Source: EHR Intelligence