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Veterans Affairs chief vows to fix ‘extremely disappointing’ health record system at Spokane VA hospital

UPDATED: Thu., July 15, 2021

After a visit to the Mann-Grandstaff VA Medical Center in April, Department of Veterans Affairs Secretary Denis McDonough speaks to the media during a press conference.  (COLIN MULVANY/THE SPOKESMAN-REVI)
After a visit to the Mann-Grandstaff VA Medical Center in April, Department of Veterans Affairs Secretary Denis McDonough speaks to the media during a press conference. (COLIN MULVANY/THE SPOKESMAN-REVI)

WASHINGTON – The head of the Department of Veterans Affairs said his agency would “reimagine” its approach to a new health record system being tested in Spokane after watchdog reports found the flawed rollout hurt productivity and threatened patient safety.

Calling the findings of an internal review he ordered in March “extremely disappointing,” VA Secretary Denis McDonough told the Senate Committee on Veterans Affairs on Wednesday he would not let other hospitals adopt the system until problems at the Mann-Grandstaff VA Medical Center are fixed. But he declined to say how much longer the hospital’s staff and the more than 30,000 veterans they serve in Washington, Idaho and Montana will have to deal with glitches that have left staff demoralized and veterans without their prescriptions.

The VA chief said the problems were caused by bad management and planning, not the software itself, which was developed by Cerner Corporation after the company secured a 10-year, $10 billion contract in 2018.

“Most challenges were not breakdowns in the technology, nor of the great people at Mann-Grandstaff who did the best they could in the worst of circumstances,” he said. “Instead, the missteps were ours at VA and Cerner, and now that we’ve identified those problems we can solve them.”

The Trump administration awarded the contract to Cerner without going through a competitive bidding process because the Kansas City-based company was already developing an electronic health record system, or EHR, for the Pentagon to manage health records for active-duty members of the military, despite that system causing similar problems when it was rolled out starting at Fairchild Air Force Base and three other bases in Washington.

Sen. Patty Murray, a Washington Democrat who sits on the VA Committee, pointed out to McDonough that she had raised the same concerns about prescription mix-ups and delayed care when Cerner won the contract in 2018. The official value of the contract has since been increased to $16 billion, but a report released by the VA inspector general’s office last week found the agency had underreported the true cost by more than $5 billion.

Murray told McDonough, a former White House chief of staff President Joe Biden picked to lead the notoriously cumbersome agency that runs the nation’s biggest hospital network, she understood he wasn’t responsible for the flawed rollout but expected him to fix it quickly.

“I know you inherited it,” Murray said. “But I know we confirmed you for this position because of your management skills and your ability to tackle hard problems.”

The committee’s GOP members were similarly understanding. Sen. Tommy Tuberville, an Alabama Republican who spent most of his career as a college football coach, compared McDonough’s position with taking over a football program and being expected to win without a quarterback or offensive line.

A separate report the agency’s inspector general also released last week found the VA and Cerner failed to adequately train employees at Mann-Grandstaff before deploying the new system last October.

In a particularly damning finding, the independent watchdog reported the VA office responsible for managing the EHR rollout altered data to show 89% of employees had passed proficiency tests, when in reality less than half that many – 44% – had shown proficiency with the new system.

Sen. Jon Tester, a Montana Democrat who chairs the committee, told The Spokesman-Review after the hearing the Trump administration had pushed to deploy the new EHR in Spokane before it was ready, with VA officials calling the October rollout in Spokane “flawless.”

“I think this whole project was rushed, because it was rolled out two or three weeks before the election to make the president look good,” Tester said. “And that rushing, I think, cost us a lot.”

The inspector general’s reports also found the VA and Cerner had failed to build the physical infrastructure needed to accommodate the new system, including rooms to house new servers. Murray cited one case where a server in Spokane was covered with a tarp to prevent a water leak from destroying it.

McDonough told the senators his department would not move forward with the EHR rollout – the next deployments are planned for VA medical centers in Washington, Idaho and Oregon and the upper Midwest – until each of those hospitals demonstrate they have both the physical infrastructure and training necessary to implement it.

He also said he would revamp the organizational structure to manage the effort and suggested those responsible for doctoring the test data could lose their jobs, although he said no VA staff had yet been fired over the problems the internal review had found.

Congress will continue its oversight of the EHR rollout at Mann-Grandstaff in a hearing of the House VA Committee next Wednesday.

Orion Donovan-Smith's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.

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