VA Deputy Secretary Donald Remy told the House subcommittee charged with overseeing the rollout of the new system he plans to visit Mann-Grandstaff VA Medical Center in Spokane in two weeks. The visit is partly in response to an internal survey in which the overwhelming majority of Mann-Grandstaff employees reported burnout and plummeting morale due to problems with the software used to manage patients' information, known as electronic health records or EHR.
"Regardless of what's happened before and regardless of how long I've been in this job, I am here now, and that means I own it," Remy, who was confirmed by the Senate in July, told lawmakers. "Our handling of EHR to date has failed to live up to this program's promise, both for our veterans and our providers."
The system is intended to track patients' health conditions, past visits, treatments, prescriptions and other medical history. It also allows veterans to schedule appointments and order prescription refills. Both providers and clients have found the new system difficult to use.
Rep. Cathy McMorris Rodgers, R- Spokane, told Remy her office has received 138 complaints from local veterans about the software, developed by Cerner Corp. through a contract expected to cost taxpayers at least $16 billion. While VA Secretary Denis McDonough told lawmakers in July he would not implement the EHR at other VA facilities until the problems at Mann-Grandstaff were fixed, Remy confirmed Tuesday that the agency plans to deploy the system at the medical center in Columbus, Ohio, in February.
"There's a sense that you're moving on to Columbus and you're done at Mann-Grandstaff," McMorris Rodgers said. "So I just, on behalf of the veterans in Eastern Washington, need to know that you are listening to their concerns and that you are committed to addressing these underlying technical problems that we continue to face."
Remy responded that Mann-Grandstaff would remain a priority even after the VA rolls out the system at other facilities, but Rep. Matt Rosendale of Montana, the top Republican on the panel, cited a growing number of patient safety issues reported by staff and argued the problems at Mann-Grandstaff are too serious to justify the department moving on to other cities.
Since the new system was implemented in October 2020, employees have reported a total of 829 patient safety issues, Rosendale said, 576 of which were directly related to the Cerner EHR. On April 14, Mann-Grandstaff director Dr. Robert Fischer told the committee there had been 247 such reports in roughly the first six months using the new system, suggesting that the rate of reported problems has increased while the VA and Cerner have sought to work out the problems.
The problems aren't confined to Spokane. Mann-Grandstaff operates outpatient clinics in Wenatchee, Coeur d'Alene, Sandpoint and Libby, Montana, that have also implemented the new software. Rep. Kim Schrier, a Democrat who represents Wenatchee, told Remy veterans in her district "have been experiencing really unacceptable delays in care and specialist referrals, inability to schedule appointments online, and then, when they try on the phone, impossible wait times."
"All of this is not just delaying their care — it is compromising their care," said Schrier, who is a physician. "If you've dedicated your life to protecting our country, it's really our responsibility to make sure you get the best service and the best care. And at least for the past year, ... the VA's really failing our veterans."
Schrier will visit the VA clinic in Wenatchee next Tuesday, her spokeswoman Libby Carlson said, and McMorris Rodgers told Remy she intends to join him when he visits Spokane in mid-November.
After McMorris Rodgers cited a question in the internal survey that found 62% of Mann-Grandstaff employees said the new EHR has made them question whether they want to keep working there, Schrier asked Remy if workers are leaving in large numbers, worsening delays and burnout for other providers.
"I haven't been made aware of any mass exodus," Remy said. "But at the same time, I'm aware of this survey."
The survey found 83% of Mann-Grandstaff employees said their morale had declined as a result of the Cerner system, Rosendale said, and 78% said their job satisfaction had worsened. But Remy repeatedly suggested the problem was a lack of understanding on the part of workers.
"It is challenging to see reflected in the survey the number of individuals that ... believe that the electronic health record system is impeding their ability to do their jobs," he said. "We're trying to make sure that we provide them with the information that they need so that they can understand how the system can actually make their jobs easier."
Democrats on the committee were more upbeat than Republicans, with Rep. Mark Takano, D- Calif., saying the new records system presents "a prime opportunity to improve what is already world-class patient care at VA," but members of both parties expressed strong concerns while emphasizing that they understood Remy and McDonough had inherited an immense challenge when they came into office.
On the day his administration announced the contract with Cerner — which was signed without a competitive bidding process — then-President Donald Trump said the new EHR would mean "faster, better, and far better quality care," calling it "one of the biggest wins for our veterans in decades."
Rep. Mike Bost, R- Ill., told Remy the panel didn't hold him responsible for the decisions made before he arrived on the job in July but expected him to address the issues before rolling out the system in the rest of the nation's VA facilities.
"The problems in Spokane will become problems in Columbus and every other facility," Bost said. "This will not change until we address the fundamental issues in the system."
© 2021 The Spokesman-Review (Spokane, Wash.). Distributed by Tribune Content Agency, LLC.
