The Department of Veterans Affairs decided in 2018 to modernize the health record system of the country’s largest hospital network. Under the best possible circumstances, this would increase efficiency and speed of care for the nine million veterans it served by 1,500 hospitals and clinics. It is a highly complex rollout scheduled to take ten years and likely will cost upwards of $16 billion — the rising costs are estimated so far at $2.5 billion for new computers and equipment needed to operate Ceres’s new software.

Two scathing reports on the initial rollout

Unfortunately, initial reports do not bode well. The VA Inspector general, which oversees auditing and investigating department programs, issued two reports in July of 2021 that were highly critical of the work so far:

No bid contract: The Trump administration awarded a no-bid contract to Cerner Corporation, a private medical records contractor. The initial 10-year, $10-billion deal is for new software for the entire system and training 367,200 employees to use it. The company underestimated the cost of the overhaul by $6 billion.

Insufficient training: The training program created by the company for VA staff was considering a waste of time by staff because it was so confusing and flawed. The first group to take the program in Spokane were tested afterward to see if they learned the system – about 44% passed. They found the new system cumbersome, and the training was so rushed and inadequate that staff productivity went down by 33%. The training was also limited because staff members were not given computers loaded with the new software to practice with before using it on the job. Trainers were also often unable to teach staff to use the system to address real-life scenarios and practical use.

Patients getting punished

The convoluted system worked so poorly during the initial trial run that it reportedly brought staff to tears of frustration. Moreover, the office in charge of running the installation did not consult with healthcare workers on the front lines using it. It led to predictably bad results for patients:

• A doctor ordered two medications for a patient, who then received 15 incorrect medications.
• There were multiple reports of prescriptions getting delayed, which led one veteran to suffer withdrawal.

The company also altered results to make itself look better. It included removing “outlier” data that made failure rates higher. The company also deleted data that may have helped them to create more effective training.

Advocacy for veterans

The problems with this new health care system will likely not go away soon, and the old system is outdated. It means that dedicated VA staff will not have the tools they need to care for this country’s veterans. It may be necessary for veterans and their families to get help navigating this flawed new system and appealing a decision if they do not get the necessary treatment and disability benefits.