The federal government's watchdog agency has recommended that the Department of Veterans Affairs postpone the rollout of its electronic health records system until problems encountered in the initial deployment are fixed.
Last fall, the Government Accountability Office identified issues with the system before it was introduced in October at the Mann-Grandstaff VA Medical Center in Spokane, Washington. Many of the problems were addressed at the initial rollout site, and the system has since been deployed at five other locations in Washington and Nevada.
But GAO officials said that, while the VA is making progress on addressing concerns, several issues remain outstanding and, if they are not addressed, risk jeopardizing the $16 billion system's effectiveness going forward.
"VA should postpone deployment of its new [electronic health records system] at planned locations until any resulting critical and high-severity test findings are appropriately addressed," the GAO report states.
VA officials maintain that the problems were "adjudicated and/or resolved and validated" before the rollout at Mann-Grandstaff on Oct. 24 and they have no plans to change the deployment schedule.
"VA successfully implemented the core electronic health record on Oct. 24 at Mann-Grandstaff, its four associated community-based outpatient clinics as well as at the West Consolidated Patient Account Center in Las Vegas with no patient safety issues," spokesman Randy Noller said.
The department awarded a contract to Cerner in May 2018 for a new electronic medical records system interoperable with the Defense Department's MHS Genesis system, also developed by Cerner. It is expected to replace the VA's VistA platform at all VA health facilities by 2028.
Adoption of a new platform, however, has been decades in the making with the VA and DoD under a congressional requirement since at least 2008 to make their systems interoperable. The DoD is currently rolling out the Cerner electronic medical records system across its health facilities with a goal to complete deployment by 2023.
The system is designed to provide a lifetime medical record for service members from the first day of military service until death.
Reviewing the rollout in Washington, GAO analysts found 378 issues they classified as "critical" or "high severity" test findings that needed to be resolved. Most were settled within months, and the VA was able to develop workarounds for 47 of 55 that had not been resolved.
The VA has said it plans to fix the remainder with subsequent introductions of the system at other sites. Yet GAO investigators said the VA should postpone deployment at new locations until all issues are addressed.
VA officials said they don't intend to do that.
"All critical and high-test findings related to go live were adjudicated. ... VA continues to follow robust mitigation processes to address risks as they emerge," Noller said. "GAO acknowledged the progress made since the last report -- proof that we can continue to move forward with deployment activity while solving identified issues at the same time."
The next location slated to receive the new electronic medical records system is the VA Central Ohio Healthcare System in Columbus. Rollout is expected to begin this spring.