WASHINGTON – In a telephone town hall meeting organized Thursday by Rep. Cathy McMorris Rodgers, Eastern Washington veterans voiced their frustration with a new electronic health records system the Department of Veterans Affairs is piloting at the Mann-Grandstaff VA Medical Center in Spokane.
Illinois Rep. Mike Bost, the GOP leader on the House Veterans’ Affairs Committee, joined the Spokane Republican on the call, which came a day after VA officials told a House subcommittee the agency would delay the system’s rollout in other parts of the country until a review of problems identified in Spokane is complete.
“Unfortunately, this system is not the improvement that we’ve been hoping for, at least not yet,” McMorris Rodgers said on the call. “Over the last few months, my staff and I have been hearing an increasing number of complaints and pleas for help.”
VA Secretary Denis McDonough ordered the probe March 19, after McMorris Rodgers called on his department to look into problems with a new online patient portal, inadequate training on the system and late, missing or incorrect prescriptions.
In the hearing Wednesday, Mann-Grandstaff director Dr. Robert Fischer told lawmakers that employees have raised 247 patient safety concerns since the system went live last October at the Spokane hospital and its satellite clinics in Coeur d’Alene, Sandpoint, Wenatchee and Libby, Montana.
“The Mann-Grandstaff Medical Center is where the rubber meets the road,” Bost said. “The initial rollout last fall looked OK, but the picture changed, and it’s changed a lot since then. Problems have been escalating as more veterans come in for care.”
Bost said primary care productivity, which he called the most important indicator at Mann-Grandstaff, declined by 38% at one point last fall.
“Productivity has improved a little bit since then, but not enough,” he said. “This is not just an issue of VA staff getting used to the new system. There are real problems with the way the system works. Doctors and nurses are having to waste a lot of time tinkering with the electronic health records when they should be caring for the patients.”
Kansas City-based Cerner Corp. secured a contract in 2018 worth up to $10 billion over 10 years to develop the new system. The contract did not go through a competitive bidding process, with Cerner awarded the deal because it was already developing a similar system for the Department of Defense, despite a Pentagon report finding the new software was “neither operationally effective, nor operationally suitable.”
Shortly after the VA system’s initial rollout in Spokane, the official in charge of the modernization effort celebrated its success, boasting that “a lot of things worked.”
According to the veterans on Thursday’s call, a lot of other things still don’t work.
A caller from Deer Park said he can no longer talk on the phone with someone at Mann-Grandstaff for help, instead getting routed to a faraway call center. A veteran in Cheney said the new online portal, unlike the old one, doesn’t let him send messages to his primary care doctor.
“We are asking the secretary not to move away from Spokane until all the fixes are done,” Bost said, adding that McDonough is aware of the problems. “This is where we’ve got to get the bugs worked out. We’ve discovered a tremendous amount of bugs, but we are working in that direction.”
“I wish I could give you an exact date,” Bost said when a caller asked how long he expected the issues to last. “The answer is: when it’s fixed.”
The VA’s rationale for awarding Cerner a no-bid contract was that the new system would be able to seamlessly integrate with the Pentagon system, ensuring consistent health care through the transition from active duty to veteran status.
“It is a system that is supposed to go from the day you raise your hand and take that oath,” Bost said, “until the day you pass as a veteran.”
But another caller from Spokane complained of a glitch that doesn’t let records transfer properly from the Defense Department system to the new VA system. McMorris Rodgers said she was aware of the issue and encouraged others to reach out to her office if they are having the same problem.
Veterans raised a handful of other concerns on the call. A caller from Spokane Valley said he had some $2,500 in medical debt from trips to the emergency room he had to take because Mann-Grandstaff doesn’t have a 24-hour urgent care center.
Fischer delayed the opening of 24-hour urgent care at Mann-Grandstaff in 2018, citing the rollout of the new health records system, which was then slated to start in March 2020. McMorris Rodgers said she continues to advocate for an all-hours urgent care clinic at the medical center.
“You think about the billions of dollars that are going into this (system), and we’re on the front lines of it,” she said, “we should be able to get that 24-hour urgent care for the veterans so you don’t end up with these kinds of bills, which is just wrong.”
McMorris Rodgers and Bost agreed with a caller from Spokane who said the blame lies with Cerner, not the VA staff in Spokane.
“In defense of all the staff there, they are absolutely doing their best,” the caller said. “I would ask that the blame doesn’t get put on the users of the system, but whoever developed it.”
Midway through the call, McMorris Rodgers invited veterans on the line to rate their experience with Mann-Grandstaff on a scale from “excellent” to “terrible.” The results: 73% said their experience has been “excellent” or “good,” while 27% said it has been “poor” or “terrible.”
Another caller from Spokane Valley, who said her husband is a disabled veteran whose care has been delayed by problems with the new system, summed up the sentiment several others expressed.
“I know that every new computer system has hiccups,” she said. “But you’re dealing with people’s lives here.”
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