Delayed care, missed diagnoses plague VA health centers following adoption of new records system

In 2018, the Department of Veterans Affairs signed a $10 billion contract with a company called Cerner Corporation to develop a new electronic health record system to keep track of patients’ data and coordinate their care.

But since the VA started testing it in Spokane in October 2020, problems with the new system have threatened veterans’ safety and caused the department to delay its launch in Western Washington and other parts of the country.

Last month, VA leaders announced that they won’t bring the system to any other hospitals until at least June of 2023, but problems persist at the facilities already using it, which now cover all of Eastern Washington and parts of Oregon, Idaho, and Ohio.

Cerner was acquired by the tech giant Oracle in a $28 billion deal that closed in June. Now called Oracle Cerner, the company has promised to fix flaws in the system that have harmed scores of veterans, according to VA patient safety experts.

Trina Parrish is one of those veterans. An Army vet, she has been the Commander of VFW Post 992 in Walla Walla for the past six years, and is a recent subject to the "glitches" in the Oracle Cerner electronic health record system. She needed an MRI on her pre-cancerous pancreas, but that didn't happen.

"The order got lost," Parrish said. "There was an order for me to get an MRI, but because I wasn't notified, my doctor wasn't notified, I had to wait for them to cancel that order and make a new one."

Now, her doctors say she needs surgery.

"The doctor wants to take out my pancreas, spleen, and gall bladder," Parrish said. "If they take it out before it turns cancerous, I have a 75% chance of living after seven years."

The MRI wasn't the only issue she has faced.

"There are delays on being able to see your test results," Parrish said. "When I went to my primary care doctor after [it] was implemented, she could not get in to see my lab results."

Walla Walla veterans were aware of these issues before the system launched there in March of this year.

"Patty Murray and McMorris Rogers aides came in, and they asked me to put the word out," Parrish said. "We had veterans come in, ask about it and say, 'There are a lot of problems going on. Why you got to still roll it out? You're harming veterans.'"

Reporter Orion Donovan-Smith has been covering the system’s impact on the Northwest over the past two years for The Spokesman-Review in Spokane. He joined Soundside to talk about the impact this shift has had on Washington state veterans. He started by explaining how we got here.

Back in 2017, the Trump administration decided that the VA needed to buy a commercial system in order to coordinate better with the system used by the Department of Defense at their clinics and hospitals.

The Department of Defense had bought a Cerner system itself a few years earlier under the Obama administration, and the Trump administration decided to buy that same system for the VA.

Integrating the new electronic health record system into Mann-Grandstaff VA Medical Center in Spokane did not go smoothly. Reports by the VA Office of Inspector General and other government watchdog agencies showed several problems early on, including patient records that were not accurately transferred from the old system to the new one.

That spiraled into even more problems. For instance, veterans who rely on getting their medications mailed to them had addresses that were incorrect, or old addresses copied over.

That led to them not getting the medications they needed, and in many cases, those veterans were suffering withdrawals from not getting those important medications.

"Appointments were delayed, follow up care was delayed," Donovan-Smith said. "Those problems have persisted even as VA and Cerner has made an effort to address them in the last two years."

In September, Orion Donovan-Smith reported about veteran Charlie Bourg, who was another victim of the Oracle Cerner electronic health record system mismanagement.

"This is a veteran who lives north of Spokane, who has been very outspoken as an advocate for veterans and for VA employees for years," Donovan-Smith said. "And it just happened — as he was looking for veterans harmed by this new system — we realized that he was one of them."

Bourg was diagnosed with cancer, but that diagnosis came a full year too late.

"Internal documents from VA confirmed that and have shown that a couple of different problems with the new computer system contributed to or caused that delay."

October of 2020 brought the launch of the new electronic health record system in Spokane, as well as its outlying clinics in Wenatchee, Coeur d'Alene and Sandpoint in Idaho, and Libby, Montana.

It launched in Walla Walla in March of this year, at the Jonathan M. Wainwright Memorial VA Medical Center, followed by Columbus OH, and the cities of Roseburg and White City in Oregon.

There was a plan to roll the system out at VA Puget Sound Health Care System in Seattle, but that has been delayed until June 2023.

As of Monday, more than 71,000 veterans have been notified that their care may have been impacted, including more than 17,000 in Spokane, and another nearly 11,000 in Walla Walla.

According to Donovan-Smith, this "doesn't mean that they've all been negatively impacted by the system. But VA has looked at their data and determined that those veterans may have been impacted.

"That could mean that their appointments were delayed or accidentally cancelled," Donovan-Smith continued. "It could mean that their medications were not renewed properly. And what VA is asking those veterans to do is to check their records, to contact their primary care doctors and make sure that they are getting the health care that they need."

Donovan-Smith still has questions about what's next.

"What does fixing it mean?" he asked. "It's not going to be perfect — none of these computer systems are perfect. But at what point will be a leaders decide it's ready to go for places like Seattle? And what will that mean for veterans and for providers there?"

Donovan-Smith also raised questions about what fixing the system will look like in Spokane or Walla Walla.

"Because even if it's not being used at new sites, those problems are still persisting, and veterans and health care workers are frustrated by them," he said. "And there's big concern about what it could do to those facilities' ability to just keep their staff, and to keep operating and providing the care that they are there to meet their mandate."

You can listen to the entire interview by clicking the audio above. And if you are a veteran who has been negatively impacted by this new system, we would like to know. You can contact us through the feedback form below, or email us at soundside@kuow.org.