A new report from the Government Accountability Office (GAO) finds that the Department of Veterans Affairs (VA) has not established goals to assess user satisfaction of its Electronic Health Records Modernization (EHRM) program.
The VA’s EHRM program has faced a troubled rollout, resulting in the VA to pause all future EHRM deployments – with the exception of one planned for 2024 – while it focuses on improvements at the five sites where the EHR system is currently deployed, as part of a larger program reset.
However, GAO’s new report warns that the VA needs to fully implement the leading practices for change management, or risk “continuing change management challenges that can hinder effective use of the new electronic health record (EHR) system” at future deployments.
“VA has not established targets (i.e., goals) to assess user satisfaction. Until it does so, VA lacks a basis for determining when satisfaction has sufficiently improved for the system to be deployed at additional sites,” the report says. “Such a basis helps ensure that the system is not deployed prematurely, which could risk patients’ safety.”
Most users of the new EHR system have expressed dissatisfaction. According to GAO, VA’s 2021 and 2022 surveys showed that users were not satisfied with the system’s performance or training.
For example, about 79 percent of users disagreed or strongly disagreed that the system enabled quality care. Additionally, GAO said about 89 percent of users disagreed or strongly disagreed that the system made them as efficient as possible.
In another recent survey conducted by the House Veterans’ Affairs Technology Modernization Subcommittee, the subcommittee discovered that VA pharmacists say they do not trust the EHR system and live in a state of “hypervigilance” as a result.
“Additionally, although VA has assessed the system’s performance at two sites, as of January 2023, it had not conducted an independent operational assessment, as originally planned and consistent with leading practices for software verification and validation,” the GAO report says. “Without such an independent assessment, VA will be limited in its ability to (1) validate that the system is operationally suitable and effective, and (2) identify, track, and resolve key operational issues.”
GAO made 10 recommendations to VA, including addressing change management, user satisfaction, system trouble ticket, and independent operational assessment deficiencies. VA concurred with the recommendations.