GAO Recommends VA Pause EHR Deployment to Resolve Issues

The Government Accountability Office recommended in a Feb. 11 audit that the Veterans Affairs Department postpone additional deployments of its new electronic health records system until numerous issues are resolved.

Two years after inking a $10 billion contract to acquire a commercial health records system, VA deployed its first instance of the software in October at the Mann-Grandstaff VA Medical Center in Spokane, Washington.

An audit released Feb. 11 indicates VA deployed the software without addressing all technical issues it identified that could have brought the system crashing down.

“Specifically, 17 critical severity test findings and 361 high severity test findings remained open as of late September 2020,” the audit states. “As a result, VA was at risk of deploying a system that did not perform as intended and could negatively impact the likelihood of its successful adoption by users if these test findings were not resolved prior to initial deployment.”

Ultimately, GAO’s audit concludes VA addressed each critical severity test finding and all but 55 remaining high severity test findings, using a combination of “workarounds that were accepted by the user community” to comply with recommendations GAO made in October.

“Nevertheless, as the department moves forward with deployment of additional capabilities at new locations, VA will likely identify new critical and high severity test findings,” the audit states. “If VA does not close or appropriately address all critical and high severity test findings prior to deploying at future locations, the system may not perform as intended.”

VA has been working on the Cerner Millennium program since 2018 following a $10 billion contract with the commercial EHR provider with the stated goals of replacing its 30-year-old in-house built VistA system and interoperability with the Defense Department’s health records system. Because the project is so technically complex and expensive, Congress has taken a more active role in overseeing its execution through hearings with VA officials and through reviews by GAO, its investigative arm.

In its Feb. 11 audit, GAO said VA has “made progress” in preparing for a new EHR by “making system configuration changes, developing system capabilities and system interfaces, conducting end user training and completing system testing events.”

“However, the department has not resolved all current critical and high severity test findings,” the audit states. “Without resolving such findings and addressing any new critical and high ones identified in the remaining days before planned deployment, VA is at risk of deploying a system that does not perform as intended, could negatively impact patient safety and could decrease the likelihood of successful system adoption by users.”

GAO recommended VA postpone deployment of the new EHR in new locations until all existing high-severity and critical test findings are resolved and closed. VA concurred “in-principle” with the recommendations but did not commit to postponing new EHR deployments. Instead, VA said it would “appropriately adjudicate” critical and high-severity test findings.

“In the meantime, VA will continue to launch the new EHR as planned,” the agency said in the audit.

VA did not respond to a request for comment by press time Thursday.