VA EHR has recorded 826 serious performance incidents since its implementation

According to a report by the VA Office of Inspector General (OIG), there have been more than 800 serious performance issues since the Department of Veterans Affairs implemented its new electronic health record system.

In May 2018, VA awarded a 10-year EHR contract to health IT vendor Cerner (now Oracle Health). Since system deployment began in October 2020, end users have experienced hundreds of severe performance degradations at the five medical centers where VA initially implemented the system.

A performance incident is defined as major if it causes severe system degradation, results in loss of services required for critical operations, or impacts patient care and requires a response beyond routine incident management.

In response to these issues, the VA halted all planned EHR deployments in July 2022, with the exception of the implementation at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, on March 9, 2024.

However, there were repeated serious performance losses until March 2024.

The OIG report found that VA and Oracle Health did not have sufficient controls to prevent system changes from leading to major incidents. In addition, VA and Oracle Health did not have sufficient controls to respond to major incidents and mitigate their impact when they occurred.

The OIG audit found that 360 serious performance incidents occurred between October 24, 2020, and August 31, 2022.

For example, on March 3, 2022, the EHR at the Mann-Grandstaff VA Medical Center in Spokane, Washington, was down for 27 hours and seven minutes due to a system change that halted operations. The medical center's director noted that many patients had to reschedule their appointments.

“Although some of the problems identified in this report also stem from other causes identified by the team, the inadequate controls to handle serious incidents ultimately lay in the way the May 2018 contract was written,” the OIG authors said.

In May 2023, VA updated its contract with Oracle Health to strengthen requirements for managing major incidents, but system issues remain.

From the system's launch on October 24, 2020, to March 31, 2024, there were 826 major performance incidents, including outages, performance degradation, and incomplete functionality.

The OIG report emphasized that while the VA updated its EHR contract in May 2023, it should consider additional controls to prevent further incidents and strengthen the department's and contractor's response to them.

“If no action is taken to improve EHR operations, severe performance degradations will continue to occur, leading to further delays in EHR system implementation while compromising patient safety,” the report’s authors write.

‍Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.