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VA delays computer system’s launch in Boise as Senate hearing spotlights harm, massive cost increase

The VA logo is seen at the entrance to the Veterans Affairs building in Washington, DC on July 6, 2022.

The VA logo is seen at the entrance to the Veterans Affairs building in Washington, DC on July 6, 2022. (Carlos Bongioanni/Stars and Stripes)

WASHINGTON (Tribune News Service) – In a last-minute decision Wednesday, the Department of Veterans Affairs delayed a planned Saturday launch of a troubled computer system in Boise after a watchdog report linked in the system of 149 injury cases at the Spokane VA hospital.

VA Secretary Denis McDonough confirmed the decision to reporters minutes before a Senate hearing focused on a report published Friday by the VA Office of Inspector General. The hearing found that the system health care providers relied on to track patient data and coordinate care effectively missed thousands of referral orders, resulting in delayed veterans care and injury.

Senator Patty Murray, a Washington Democrat who visited the Mann-Grandstaff VA Medical Center on July 7, told four VA officials who appeared before the Senate Veterans Affairs Committee that their testimony contradicted what she had heard from veterans and clinicians in Spokane.

“Frankly, I’m pretty upset about what I’m hearing,” Murray said, pointing to flaws in the system that threaten care. “And the VA’s written testimony does not match what I heard from the providers. I don’t want to hear a rosy picture that minimizes concerns – I don’t want to hear any of that. The VA may have inherited this program, but it’s yours now, and the VA owes our veterans a system that works and puts patients first.

Murray, along with Rep. Cathy McMorris Rodgers, R- Spokane, has repeatedly demanded that the VA fix problems with the system before rolling it out to other sites in Washington.

After launching Mann-Grandstaff and its affiliated clinics throughout the Inland Northwest in October 2020, it has since rolled out facilities in Walla Walla as well as in Oregon and Ohio.

The system was set to roll out in Seattle and other Puget Sound sites in August until The Spokesman-Review obtained a draft of the Inspector General’s report, which prompted VA leaders to delay the deployments. until March 2023. But as of Wednesday, the launch in Boise has been pushed back just one month to July 23.

At his monthly briefing with reporters, McDonough declined to give a clear answer when asked why a system the VA has determined is too unreliable for Seattle or Boise is safe to use in Spokane, Coeur d’ Alene, Richland and other cities in the Inland Northwest where it has been rolled out.

The VA plans an effort to replace its current electronic health record system with one made by Oracle Health, formerly known as Cerner, will cost $16.1 billion over 10 years. At Wednesday’s hearing, Senate VA Committee Chairman Jon Tester, D-Mont., revealed that the nonprofit Institute for Defense Analyzes estimated the project would cost $33.6 billion to implement over 13 years and a total of $50.8 billion. to continue for 28 years.

Oracle, which acquired Cerner in a $28.3 billion deal that closed in June, is set to receive at least $10 billion for the system under a contract signed by the Trump administration in 2018.

“This should serve as a wake-up call to everyone,” Tester said, “including the people at the VA, Oracle Cerner and of course us — Congress — because we still have a lot of work ahead of us.”

Terry Adirim, who heads the VA office that oversaw the rollout of the Oracle Cerner system in January, told senators he could not make the same decisions as his predecessors but insisted the system is improving.

“I’ll be honest,” said Adirim. “In hindsight, Mann-Grandstaff is not yet ready to adopt the new electronic health record.”

“But that was almost two years ago,” he said, adding that his office has learned valuable lessons from Spokane’s mistakes. “As we plan to continue with other deployments, we are more engaged with our previous sites, closely monitoring and evaluating for user experience and adoption.”

Getting a hospital back to its normal operations after implementing a new electronic health record system could take up to six months, Adirim told senators. But more than 18 months after the system was launched in Spokane, it is still often unavailable due to breakdowns and service degradation.

The VA’s top patient safety expert, Gerard Cox, also told senators that the problem that caused at least 149 injury cases has not been fully resolved. When Murray asked Cox if it was responsible to continue using the Spokane system, he gave a revealing answer.

“The only way this system is being used effectively, I believe, is because … our dedicated employees are putting in double time, double-checking, triple-checking things,” he said. “That’s not the way it’s supposed to work.”

When Murray again asked if the safety expert believed the system should still be in use, Cox said, “I believe we’ve taken enough steps to build additional safeguards, knowing where vulnerabilities, based on the Spokane experience, to reduce the risk of further damage.”

Murray also asked Adirim about the number of interruptions in the system, which a document obtained by The Spokesman-Review suggests is more frequent than the VA admits. Adirim responded that he was not familiar with the document, although The Spokesman-Review shared it with the VA before publishing the story.

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


(c)2022 The Spokesman-Review (Spokane, Wash.)

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