Data gap poses risks for launch site of VA’s new health record

VA Deputy Secretary Donald Remy speaks at a White House event in April 2022.

VA Deputy Secretary Donald Remy speaks at a White House event in April 2022. Stefani Reynolds/AFP via Getty Images

The commercial electronic health record system being introduced by the Department of Veterans Affairs is proving difficult and expensive to adapt to the agency’s data reporting requirements.

The Cerner electronic health records system the Department of Veterans Affairs acquired for $10 billion over 10 years to replace its homegrown Vista software is falling short on data reporting requirements, according to a watchdog report.

The VA’s Office of Inspector General reported on Wednesday that the Mann-Grandstaff Medical Center in Spokane, Washington, the first site to implement the new health record system, isn’t providing metrics needed to support the hospital’s accreditation. A loss in accreditation “may affect patient’s trust in the facility and can also hinder the facility’s ability to recruit quality staff who may prefer to work for an accredited facility,” the report states.

The OIG found that “gaps in available quality and patient safety metrics, more than a year after go-live, hindered publication of quality and patient safety metrics as legislatively required.” 

The go-live for the Cerner software at Mann-Grandstaff took place in October 2020. Several oversight reports from VA’s watchdog have identified multiple issues relating to workflows, training, patient safety and more. The project, which is expected to cost at least $21 billion overall, includes a $10 billion contract with Cerner for software, storage and services.

A Veterans Health Administration official interviewed for the report told the OIG that the agency decided to try to produce reports internally after learning that Cerner would charge $12 million for 50 metrics reports and noted that Cerner did not appear to have the expertise sought by VHA when it came to metrics.

Cerner has “had lots of people leave, lots of buyouts,” the official was quoted as saying in the report. “So sometimes you’ll get somebody that has 20 years. Sometimes you’ll get somebody that just came out of college. We would get stuff when we were validating [metrics reports created by Cerner] that didn’t work right off the bat. Had spelling errors, you know, just simple, simple things.”

Cerner was recently acquired by Oracle for approximately $28.3 billion. Oracle announced on Wednesday that the deal was cleared by U.S. antitrust regulators.

The OIG report included two recommendations for VA Deputy Secretary Donald Remy, whose position includes executive oversight of the Electronic Health Record Modernization program. The report requests that Remy evaluate gaps in metrics and examine issues around the availability of data and taking corrective action as needed. VA agreed with both recommendations and expects to complete the work by October 2022.

In reply comments, Remy noted that many of the problems flagged in the report, which was based on an investigation conducted from July to October 2021, have already been addressed.

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