The Department of Veterans Affairs (VA) has faced a long, troubled rollout of its Electronic Health Records Modernization (EHRM) program; however, leaders at VA healthcare facilities believe while the new EHR system is not perfect yet, it is their best option moving forward.
At a House Committee on Veterans’ Affairs hearing on Thursday, leaders at four out of the five sites where the EHR system is currently deployed shared their struggles with the existing system – with all agreeing that their productivity has decreased since implementation.
“We set aggressive goals to try to reach our pre-deployment productivity and access. We have unfortunately found that the new electronic health record has largely provided no meaningful improvements in safety, efficiency, or communication,” said Dr. Meredith Arensman on behalf of the VA’s Chalmers P. Wylie VA Ambulatory Care Center located in Columbus, Ohio.
“Our clinicians are exhausted, sometimes tearful, and frankly distressed that they’re not able to provide the level of care that they could in 2019,” she added.
The VA’s EHRM program is currently in the middle of a “program reset,” while the VA and contractor Oracle Cerner focus on improvements at the five sites where the EHR system is currently deployed.
The VA acquired Oracle Cerner’s Millennium EHR platform in 2018 to replace the Veterans Health Information Systems and Technology Architecture (VistA) system – a legacy system that also has its flaws.
“We understand we can’t flip the switch and go back to the legacy system – although there are days that would be our preference. We hope for a dynamic, intuitive, and adaptable system that meets the unique needs of veterans,” Dr. Arensman said.
Rep. Greg Murphy, R-N.C., a doctor himself, slammed the new EHR system and suggested that there should be “another system” in place instead of the Oracle Cerner one.
“I’ve been a surgeon for 30-plus years, I would consider this an absolute failure,” Rep. Murphy said. “If you have an error rate that is higher now, an inefficiency rate higher now, five years afterward, it’s an absolute failure.”
“So, my recommendation – I’ll be very plain and simple with it – I think Cerner has failed you, I think it will continue to fail you, and I believe you ought to cut the cord and go to another larger system,” he added.
Nevertheless, Dr. Neil Evans, acting program executive director of the EHRM Integration Office – along with leaders of the VA healthcare facilities – agreed that they should move forward with the Oracle Cerner system in place.
“We are committed to moving forward. We have invested a significant amount in the success of this project,” Dr. Evans said. “I think we’re beginning to see improvements as a result of the reset. It’s slow and incremental, and we expect it and, frankly, it must accelerate. But, I still believe that we should proceed forward.”
While the VA site leaders were skeptical of moving forward with the existing EHR, they expressed their hope that these improvements will only continue.
“The system as it exists now is currently not meeting our needs. Having said that, there have been marked improvements in specific areas,” said Thandiwe Nelson-Brooks on behalf of the Roseburg, Ore., VA Medical Center.
“So, while we’re not where we need to be,” she continued, “we believe that the VA central office has made the right decision to commit to getting this right at the sites where the system currently exists.”
“I think to be fair to the majority of my staff, they would say that the current system is not yet meeting their needs,” added Dr. Arensman. “And they would say there needs to be major changes, not just in terms of incremental gains, but really human-centered design to make this an efficient and usable system for the future of the VA.”