- The Government Accountability Office in a new report said the U.S. Department of Veterans Affairs could be more inclusive as it makes efforts to revamp its "antiquated" electronic health records system, in particular when handling stakeholder input on how its system should be deployed and operated.
- Of particular concern is that workshops held in VA locations where the first new EHR systems were installed did not include a diverse range of stakeholders, which the GAO blamed on internal communication lapses within the VA. Among those left out of those sessions were some specialty physicians, according to the report.
- The GAO recommended the VA improve its communications processes as part of further EHR implementation at other facilities, although it did not make specific recommendations as to how to accomplish that. The VA concurred.
Of all the things the network of VA hospitals and clinics have come under fire for in recent years, its EHR system has drawn increasing flak. Critics say the system has made it challenging to effectively and inexpensively keep tabs on patients and deliver appropriate healthcare services.
The VA has spent billions of dollars on the new EHR system from Cerner, and it says that some 78 billion records have been transferred to a centralized database. Until the COVID-19 pandemic temporarily shelved the new EHR implementation, plans had been in place to deploy the new system at two VA facilities in Washington state later this year.
To prepare for deployment, the VA established 18 EHR councils, which were comprised of a 60-40 split between VA field employees and managers. Eight nationwide workshops were held in 2018 and 2019 to get input from VA clinicians, employees and others who might have to access the new system. Any issues that came up could be pushed up from the councils.
But according to the GAO, concerns were raised from officials at the two initial EHR implementation sites that specialty physicians were underrepresented, specifically pulmonologists and gastroenterologists. VA leadership said this was likely due to the initial focus on soliciting input from primary care physicians, who would use the system most often. The same issue was also brought up at one of the national workshops.
Moreover, staff at the two sites in Washington also raised concerns that they did not receive clear enough communications to know which specific local meetings they should have attended.
In response, VA said it was "further refining local workshop agendas and descriptions to facilitate VA subject matter expert identification and participation," according to the report.
As the VA's EHR implementation chugs along, the nation's current patchwork EHR system has been an issue in terms of compiling data regarding the COVID-19 outbreak and responding in a coordinated fashion.