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News >  Military


WASHINGTON LAWMAKERS OUTRAGED AFTER WATCHDOG REPORTS FIND COMPUTER SYSTEM HARMED
NEARLY 150 SPOKANE VETERANS AND VA LEADERS MISLED INVESTIGATORS

July 18, 2022 Updated Tue., July 19, 2022 at 8:58 a.m.

The Mann-Grandstaff VA Medical Center. Federal lawmakers were angered after
investigative findings determined that 150 veterans in the Spokane region have
been harmed because of problems with the new Cerner electronic health records
system. The report also indicates that some VA leaders in charge of training
staff in the new system misled investigators during an earlier probe into
problems with the Cerner system. (COLIN MULVANY/THE SPOKESMAN-REVI)
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By Orion Donovan-Smith orionds@spokesman.com(202) 853-2524

WASHINGTON – Washington lawmakers reacted with outrage after a report published
by an internal Department of Veterans Affairs watchdog Friday confirmed a
computer system at Spokane’s VA hospital has caused nearly 150 cases of harm,
while another report found VA leaders in charge of training users on the new
system misled investigators.

The Spokesman-Review previously reported the cases of patient harm based on a
draft report by the VA Office of Inspector General, an independent oversight
body charged with investigating the department, that found a flaw in the system
caused delays in patient care when referral orders for follow-up care
effectively went missing. The report alleges Cerner Corp., which is developing
the system under a $10 billion contract, knew about the issue but did not fix it
nor warn VA of the risks it created.

The second report found two senior VA officials gave the Office of Inspector
General inaccurate information during a previous investigation into problems
with training employees to use the new system. In one case, the officials
provided data claiming 89% of employees had passed a proficiency test, when in
reality fewer than half that many – just 44% – had shown they could use the
Cerner system. The report concluded that while the officials didn’t
intentionally mislead investigators, their “lack of diligence” hampered
oversight.

Tech giant Oracle acquired Cerner, now known as Oracle Cerner, in a $28.3
billion deal that closed in June. The company faces the task of addressing a
wide range of problems with the electronic health record system that have
reduced access to care and left VA employees exhausted and demoralized since the
system was launched in Spokane in October 2020.

Lawmakers who represent the Inland Northwest cities where the system has been
deployed – including Spokane, Wenatchee and Walla Walla – were quick to respond
to the reports’ findings on Friday, with Rep. Cathy McMorris Rodgers, R-Spokane,
calling them “even worse than I suspected.”

“I am appalled by all parties involved in this disaster,” she said in a
statement, calling Cerner’s failure to brief VA leaders and train health care
providers on the feature that caused referrals to go missing “reprehensible.”

“As for VA leadership, their manipulation of training and system proficiency
data to save face has put veteran safety at risk and is morally bankrupt,”
McMorris Rodgers said. “This agency has completely lost sight of its mission and
done irreparable damage to my trust in their ability to deliver results for
Eastern Washington veterans.”

Most of the 149 cases of harm were classified as “minor,” but there were 52
incidents of “moderate” harm – requiring a longer hospital stay or more care –
and two cases of “major” harm, defined by the VA as “permanent decrease in the
body’s functioning or disfigurement” that “requires surgery or inpatient care.”
The draft report included only one case of major harm, in which a veteran known
to be at risk of suicide was not scheduled for a follow-up appointment because
of the flaw in the system and later called the Veterans Crisis Line threatening
to kill himself.

The findings of the second report, including the VA training officials
manipulating proficiency test results, were disclosed during a Senate VA
Committee hearing in July 2021. VA Press Secretary Terrence Hayes declined to
say whether the two officials were still employed by the department, saying in
an email, “VA does not share personnel-related details about its employees with
the public or press.”

Sen. Patty Murray, a Washington Democrat who sits on the Senate VA Committee,
said the Cerner system should not be deployed at other sites “until its glaring
errors are resolved.” After The Spokesman-Review gave the VA an opportunity to
respond to the draft report revealing harm and ongoing risk to veterans caused
by lost referrals, the department announced it would delay the system’s launch
in the Puget Sound region from August to March 2023.

“My number one priority here is patient safety and, as the reports make plain,
the EHR system is jeopardizing patient safety to the tune of hundreds of
orders,” Murray said in a statement.

According to the Office of Inspector General, the Cerner system failed to
deliver more than 11,000 orders for requested clinical services between October
2020 and June 2021. While the VA and Oracle Cerner have since taken steps to
mitigate the problem, the watchdog office says it has not been fully resolved.

“As I’ve said in the past, officials need to be completely transparent and
cannot withhold or slow walk any information to the Inspector General’s office,”
Murray said. “So I’m going to carefully review these reports and continue to
hold both VA and Oracle Cerner accountable. Our veterans and the hardworking
providers on the ground, in Spokane and Walla Walla, are counting on us to get
this right, so I won’t stop pressing for solutions until this is fixed.”

Rep. Dan Newhouse, R-Sunnyside, represents a Central Washington district that
includes clinics in Yakima and Richland that began using the Cerner system in
March, when it launched at the Walla Walla VA Medical Center with which they are
affiliated.

“The details found in these reports are deeply disturbing,” Newhouse said in a
statement. “These reports highlight that the VA, and this administration,
intentionally ignored reports showing that their system was putting our
veterans’ lives at risk.”

The VA signed a $10 billion contract with Cerner under the Trump administration
in 2018, skipping the usual competitive bidding process with the justification
that the VA needed to use the same system as the Department of Defense, which
had begun rolling out a Cerner system in its facilities earlier that year,
beginning at Fairchild Air Force Base outside Spokane. Despite the Biden
administration reversing other Trump-era decisions, VA Secretary Denis McDonough
has chosen to continue the Cerner project, which is projected to cost at least
$21 billion over more than a decade when accounting for necessary infrastructure
upgrades.



The top members from both parties on the House and Senate VA committees also
released statements about the watchdog reports on Friday, with Rep. Mark Takano
of California, the top Democrat on the House panel, saying he was “extremely
disappointed” by the VA’s lack of transparency.

“We have been concerned about patient safety and the possibility of patient harm
from the very beginning of this project,” Takano said. “We have repeatedly been
assured by the highest levels of VA and the program office that no veterans had
been harmed by the transition to the Oracle Cerner Millennium product. Today’s
report by the VA Office of the Inspector General shows that we had not been
given the whole story.”

Rep. Mike Bost of Illinois, the top Republican on the committee, visited VA
facilities in Richland and Walla Walla with Newhouse in early July.

“Instead of fixing the issues with the system, VA and Cerner seem much more
interested in hiding them,” Bost said. “We expect honesty, at the very least,
and a plan to resolve the training and referral issues so they never happen
again.”

Sen. Jon Tester of Montana, the top Democrat on the Senate VA Committee, called
the reports “unacceptable” and said Oracle Cerner “needs to step up its game and
deliver a functioning, quality system that’ll do right by taxpayers.”

Sen. Jerry Moran of Kansas – who has been less vocal than other lawmakers in his
criticism of Kansas City, Missouri-based Cerner – didn’t mention the company in
a statement that pointed blame at the VA.

“The lack of care the department has provided to veterans impacted by the new
system is unacceptable,” Moran said. “Today’s reports illustrate patient safety
issues that can be traced directly to failures at the highest levels at VA,
including the department’s failure to ensure that personnel are candid and open
with OIG investigators working to uncover problems in the system.”

The Senate VA Committee will hold a hearing Wednesday to question VA officials
and an Oracle executive about the status of the Cerner system’s rollout. Despite
VA leaders admitting the system had not shown “adequate reliability” to be used
in Seattle and Portland, the department plans to launch it in Boise on Saturday.

Orion Donovan-Smith's reporting for The Spokesman-Review is funded in part by
Report for America and by members of the Spokane community. This story can be
republished by other organizations for free under a Creative Commons license.
For more information on this, please contact our newspaper’s managing editor.


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