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Opinion >  Guest Opinion

Edward Francis Meagher: VA must stand down it’s electronic health record modernization program

Edward Francis Meagher

By Edward Francis Meagher

When the software on the new Boeing 737 MAX caused two of the planes to crash, the FAA grounded all 450 of them immediately to prevent the possibility of future harm.

When two babies died after consuming baby formula, the FDA immediately shut down the plant producing the formula to prevent the possibility of future harm.

On average, about 4,500 drugs and devices are pulled from U.S. shelves each year by the FDA to prevent the possibility of future harm.

The Department of Veterans Affairs, however, refuses to shut down its sole-sourced, $16 billion dollar award of its electronic health record modernization program despite hundreds of documented cases of veteran patient harm.

This indefensible and inexplicable stubborn disregard of the health and well-being of our nations veterans defies logic and threatens the credibility of the entire VA health care system.

A little background is in order.

After years of the systemic system failure of the Department of Defense’s (DoD) electronic health record, AHLTA, DoD awarded a contract for a replacement system called Project Genesis. This system, during the eight years of its existence has been plagued with budget, schedule and performance issues.

In 2017, during the height of these problems, a political decision was made to impose the Genesis-derived EHR system on the VA to provide additional financial and technical support to this failing program without having to admit program deficiencies. The two political rationales put forward to justify this $16 billion dollar sole-source award was that the VA’s current system, VistA, was old and needed replacement and that the only way to share a complete longitudinal health data record was to have all systems on the same branded, proprietary system. Both statements are demonstrably false.

Since 2017, the VA has expended every effort, spent every available dollar and placed the entire VA staff and systems under debilitating pressure to make this politically imposed system work.

This system is not working and will not work for the VA. Worse yet, it is causing veteran patient harm and destroying the lives and morale of the clinicians and practitioners who are being forced to use it.

Several recent VA Office of Inspector General reports have documented hundreds of instances of patient harm as a direct result of the imposed system. Surveys have documented the impact of this system imposition on staff morale to the point that 65% of personnel who are being forced to use it say they will seriously consider leaving the VA if continued to be forced to use the system.

The VA has even acknowledged this imposed system is not suitable for use by canceling all future installations until the second quarter of the 2023 fiscal year. Yet it insists on continuing to subject the veterans being treated at the VA facilities where this system has already been installed to this dangerous and unreliable system. VA leadership is willing to treat the veterans and staff at these facilities as guinea pigs in their mindless, unethical and immoral fanaticism to force this system into production. Whether the reasoning behind this irrational behavior is a result of contracting pressures, misunderstanding of the technology or just ego driven stubbornness is of little importance. What is important is that veteran’s lives are at risk and what passes for VA leadership has taken an oath to not let that happen. Continuing to use this system on veterans is a total abrogation of their oath. The VA must immediately revert the five current live production test sites to the reliable, fully functioning VISTA system in use at the 130 other VA health care facilities and stop this dangerous experimentation with the lives and health of America’s veterans. Veterans have been harmed and continue to be exposed to harm daily and it must be stopped immediately. VA leadership must be held accountable for their decisions and the harm they cause.

Edward Meagher resides in Great Falls, Virginia, and is retired after 24 years in government, 26 years in the private sector and four years in the U.S. Air Force. He is a Vietnam service-disabled veteran. He served for seven years as the deputy assistant secretary and deputy CIO at the Department of Veterans Affairs.

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