Spokane, Washington, is considered the center of the Department of Veterans Affairs’ latest technology, the first site in the department’s ten -year plan to change its medical history program. But one morning in early March, some doctors made a mistake in the new system.
At Spokane’s Mann -Grandstaff VA Medical Center, the history system is down – built by Cerner Corp., based in North Kansas City, Missouri. The staff, both inside the hospital and its outlying hospitals, have returned to relying on pen and paper. Computer programs cannot be downloaded. Doctors cannot prescribe or change patients’ medications.
The next day, only electronic medical records were available. Many of the records continued to be “sequestered”, meaning doctors and nurses struggled to increase medical records.
The snafu, the latest in a series in Mann-Grandstaff, has fueled the anger of Spokane medical staff with a system that has been in trouble since it was introduced a year and a half ago. The VA said the patients were not injured as a result of the complications.
But doctors in the country say it is only a matter of time before serious safety issues – those of injury or death – arise, pointing to the ongoing weaknesses of the program amidst the crisis. VA leads the full implementation of the country. One supplier said he was happy he had no relatives in Mann-Grandstaff.
The one-two pounding of a horrific accident and employee grievances is the latest return to the VA’s efforts of more than $ 16 billion to improve its record keeping technology. The crisis required doctors to diagnose minor ailments and filed tens of thousands of requests to help Cerner with safety-related issues, council reviews and watchdog officials said.
If those problems are compounded on the large VA system – which employs more than a quarter of a million employees and serves 6.3 million patients – it could create safety and product safety problems. While the VA’s goals are to use technological improvement to provide clean records for patients from enlistment to discharge, doctors and nurses believe talks with KHN to repeat the problems found in Spokane.
The recording system, which is scheduled to be deployed at several VA offices in the North Pacific in the coming weeks and months, is currently being rolled out at Jonathan M. Wainwright Memorial VA Medical Center. in Walla Walla, Washington.
Both Cerner and Mann-Grandstaff officials denied the allegations and handed KHN over to officials at VA headquarters in Washington, DC.
“If there’s a total meltdown” in Walla Walla, says Katie Purswell, the United States Director of Antiquities and Renovation, it’s a problem for the office and its decade -old. Initial expectations from staff were positive, but problems appeared in Spokane in the weeks after the system began.
The crisis was severe in early March. On March 2, Cerner turned a software update to a database that contained medical information. Problems arose the next morning. In the story of the patient undergoing surgery, the staff saw incorrect information, including male diagnosis of another disease. About an hour later, an employee from the VA’s medical records office told some doctors in Mann-Grandstaff to “get out.”
Robert Fischer, director of the Mann-Grandstaff Health Center, sent a message later that morning. “You think all the electronic data is inaccurate,” Fischer said in an email. He urged doctors to limit prescriptions for lab work, imaging studies, and medications. The factory has moved to “downtime processes,” which means reliance on paper.
Some staff did not access the early morning memo and continued to incorporate the information into the combined records, adding a stew of erroneous data.
According to information provided to Congress later by the VA, Cerner told Mann -Grandstaff a “complete humiliation” the night before – leading to questions from employees about the reason until early morning the next day to shut down the system. Office manager Erin Crowe told KHN there would be no delay in announcing the staff.
Problems arose the next week. Some records – 70 on March 10, such as a draft presented to Congress – were not used when auditors tried to find information gathered from other documents. This left physicians sometimes unable to manage the care of patients. The doctors said it became confusing and confusing. They are unable, for example, to help patients complete prescriptions.
Members of Congress were worried – not only about the outcome but the VA’s explanations for it. In a letter to the industry leader, leading Republicans on the Veterans House Professional Committee and a subcommittee overseeing the technology, Rep. Mike Bost of Illinois and Rep. Matt Rosendale of Montana, expressed concern the industry is “soft-pedal[ing]”His comments and it is argued that the ancients were misled by the fact that the stories were edited.
The full committee plans to conduct an in -depth investigation. He set up a locker room with VA staff from Spokane and Walla Walla on April 5th.
The damage was exacerbated at Mann-Grandstaff. The doctors there were troubled by the deep traffic system. Low times are normal, a council spokesperson told KHN.
A March 17 VA survey recorded approximately 39,000 applications for technical assistance or improvements since the October 2020 implementation of the new documentation system. Cerner employees frequently closed requests without addressing the underlying issues, the report said. Mann -Grandstaff employees were either fired or planned short pages to stop the abuse program, the Inspector -General wrote – each of the root causes of the patient safety incidents.
The agency said shortcuts – or workarounds – were not its policy. “Work is not allowed and encouraged,” Crowe said.
Director Biden has tried to revamp the software system, leaving the program on hiatus before introducing new leadership to the health history department by the end of 2021. But in the meantime, it has failed. low low. “People in Spokane VA are humbled and unhappy,” Rep. Frank Mrvan (D-Ind.), Chairman of the House subcommittee on VA technology education programs, told industry leaders during the November conference call. He said the workers told him it was as if their heads were banging on the wall to do things.
Other observers reported Mrvan’s concern.
Purswell of the American Legion asked if necessary work was being done to prepare the Walla Walla building and its staff for the technology system. He asked employees how they felt as if the Cerner system had been put on them or were happy with the change.
The VA is not aware of the benefits of the program. “I think we need to show that it’s not a loss,” Drs. Terry Adirim, director of the VA office oversaw the implementation of the new record technology. “We probably missed the point in explaining the benefits of this.”
In fact, Adirim led a virtual city office meeting on March 21 for seniors in the Walla Walla area – where he was pressured to address the problems in Spokane. “If Spokane has been thinking about this for years, why is this moving forward?” asked an interrogator, expressing an opinion that was often expressed in the call. Adirim said VA has made “thousands of changes” since its inception.
Medical professionals in Spokane and Walla Walla VA are a subset of anonymous websites that share their often negative experiences about the program even though employees feel it is hurting their profession.
Adirim believes that negative issues can be addressed by increasing technical support. He said training programs had been completed since the installation in Spokane. Bottom line: The VA continues.
“People want to go back to what they did before,” Adirim said, but he couldn’t.
KHN (Kaiser Health News) is a government news agency that publishes in -depth news coverage on health issues. KHN is one of three major projects at KFF (Kaiser Family Foundation). KFF is a non -profit organization that provides information on health issues in the nation.
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