VA and Cerner to investigate cause of Spokane electronic health records outage

The Department of Veterans Affairs and medical records company Cerner will perform a “full root cause analysis” and establish an action plan to prevent further outages after an electronic health records system was affected by a software bug earlier this month.

A department spokesperson confirmed to FedScoop that the records system was taken offline at about 1:30 p.m. on March 3 after a technical defect in a software update was discovered.

As a result of the software bug, the system mixed up certain patient records, leading staff at the Mann-Grandstaff VA hospital and associated clinics in Washington and Idaho to revert to paper records.

It is the latest problem to hit the VA’s troubled electronic health records modernization program, which has provoked ire from lawmakers and frontline medical staff.

VA has worked to rectify errors caused to veterans’ health records as a result of the system data mixup, and as of March 17 only five records remained to be corrected, the department said.

The outage affected the records of veterans receiving treatment at the Mann-Grandstaff medical center in Spokane, as well as clinics in Wenatchee, Washington; Libby, Montana; Coeur d’Alene, Idaho; and Sandpoint, Idaho.

The VA’s medical center at Spokane was the first rollout location for the department’s 10-year endeavor to move away from the open-source Veterans Health Information System Technology Architecture (VistA) and migrate VA and DOD data to a Cerner-built cloud system.

Details of the outage come after the VA’s Office of Inspector General last week published a trio of reports that identified major concerns about care coordination, ticketing and medication management associated with the EHR program launch.

In its deep-dive report looking at care coordination following the new records system rollout, the department’s OIG substantiated deficiencies over the migration of patient information, which in some cases was transferred with errors. The watchdog found also that in the new system that electronic flags to identify patients at high risk for suicide and with behavioral concerns had failed to activate.

VA’s OIG in the second instalment of its investigation highlighted concerns over the helpdesk ticketing system for the new records system, which have previously been raised by frontline staff. Among the issues identified by the watchdog were concerns that Cerner service desk support staff were not able to view and replicate reported issues, closed tickets prior to resolution and did not communicate ticket status to end users.

The helpdesk ticketing system for the EHR is run by the VA Office of Electronic Healthcare Record Modernization and Cerner.

In its third report instalment, VA’s OIG found that the new records system had on occasion discontinued future medication orders written by providers, failed to process certain outpatient medication orders and allowed registered nurses to order prescriptions without the necessary approvals from doctors. 

A Cerner spokesperson referred a request to comment to the VA.