The Department of Veterans Affairs’ new Electronic Health Record (EHR) is now running at a third location, although lawmakers remain concerned about future rollouts.

The VA on April 30 launched its new Cerner EHR at its Central Ohio Health Care System in Columbus, Ohio. The new system replaces software that’s more than 30 years old, and will track and store health information on VA patients.

The EHR went live at the Mann-Grandstaff VA Medical Center in Spokane in October 2020 and the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla, Washington.

VA Secretary Denis McDonough, meanwhile, told the House VA Committee last week that he’s “very concerned about execution of the program to date,” but will press ahead with the EHR rollout.

McDonough said the new EHR from Cerner has experienced five shutdowns since March 3, the first of which was so “egregious,” that the company’s chief executive officer issued a signed apology. Two of those outages happened last week.

“The only reason to do this is if it has clinical value and improves outcomes for our veterans. Our clinicians continue to believe that it will and that it does. If it ever stops being the case, then I’ll come here and I’ll tell you that we’re not going to proceed, but I don’t have a basis on which to make that decision yet,” McDonough told the committee at an April 28 hearing.

However, McDonough said the VA will “continue to hold Cerner accountable,” and said the agency is building on lessons learned from each subsequent EHR go-live.

“If I assess any of this to create a threat to our veterans, I won’t proceed, but to date, the experience and the learnings from Mann-Grandstaff strengthened our ability to go to Walla Walla. The experience in Mann-Grandstaff and Walla Walla continues to strengthen our ability to go to Columbus,” McDonough said.

In light of these and other recent outages, Cerner officials told lawmakers the company is considering a technical review of the EHR to ensure the system is stable and reliable for future rollouts.

Technology Modernization Subcommittee Ranking Member Matt Rosendale (R-Mont.) said VA pharmacies using the new EHR have been “forced to use dangerous workarounds,” and called the rollout thus far “a multi-billion-dollar failed experiment.”

EHR medication management issues in Spokane, Washington, also resulted in a veteran’s heart medication “falling off” the list of active prescriptions on his health record, causing him to run out of medication. The Spokesman-Review newspaper reported that the patient was hospitalized after a cardiac episode.

Rosendale said the EHR rollout has put a burden on VA employees. He said a poll of VA employees working at Mann-Grandstaff showed that 80% of respondents would prefer to work somewhere else as a direct result of the Cerner EHR rollout.

“Physicians cannot even rely upon the information that they’re reviewing to practice medicine. This is risking lives,” Rosendale said.

Members of the committee have cited continued problems at the first two sites as reasons why the agency should once again pause the rollout until it addresses the root causes of its problems.

Terry Adirim, the executive director of VA’s EHR Modernization Integration Office, said the EHR rollout marks an “important step” in bringing VA into the same health record used by the Defense Department and the Coast Guard.

“With each VA site that adopts this system, we gain momentum. The lessons we carry forward from site to site are refining our rollouts and improving end-user experiences,” Adirim said.

Adium told the subcommittee last week that the EHR is a “safe system” that DoD has running at more than half of its facilities across the country.

VA scheduled the next two EHR system deployments for June 11, and will happen in Roseburg, Oregon, and White City, Oregon.

The agency has plans for the EHR to go live at larger, more complex VA facilities in Seattle and Ann Arbor, Michigan later this year.

The Mann-Grandstaff VA Medical Center experienced an EHR  outage on April 27 as Deputy VA Secretary Donald Remy and Rep. Cathy McMorris Rodgers (R-Wash.) were touring the facility.

“I cannot emphasize enough just how important it was for him to come to Spokane and see firsthand the complications caused by the new electronic health records system, which happened to be down for 45 minutes during his visit,” McMorris Rodgers said in a statement.

McMorris Rodgers said the EHR rollout has put a toll on VA’s workforce, and that delays in restoring 24-hour urgent care access at Mann-Grandstaff “have further undermined veterans’ confidence that they will have access to care when and where they need it most.”

“The continued problems with the new system — pharmacy and prescription errors, unannounced shutdowns, a growing backlog of tickets needing attention — have caused veterans and care providers an unacceptable amount of stress and frustration,” she said.

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