VA's EHR troubles run deeper than its $16B Cerner rollout, OIG report finds

As the Department of Veterans Affairs rolls out its $16 billion Cerner EHR, a report revealed that six of the seven VA hospitals reviewed are not filling patients' records into EHRs properly, according to a June 17 Office of Inspector General report.

The VA uses non-VA providers to bring timely healthcare access to veterans when they are experiencing long wait times for services. After a visit with a non-VA medical provider, VA staff are supposed to update the EHR with the visit records so the veteran's providers have the patient's full medical history.

Five report findings:

1. The audit found that the Health Information Management staff responsible for records management was not adequately complying with VA policies on scanning and indexing non-VA medical records.
   
   
2. VA staff is required to perform quality checks on 100 percent of documents scanned. However, six out of seven VA hospitals covered by the report did not always enter non-VA medical records into EHRs correctly. At those six hospitals, there were errors in nearly half (44 percent) of cases reviewed when indexing patients' mental health records. The errors include using incorrect document titles, entering duplicate records, indexing records to the wrong patient and indexing records to the wrong non-VA care referral.
   
   
3. VA facilities are required to create policies that detail the process, time frame, and responsibilities for scanning, importing and indexing non-VA medical records in EHRs. Yet none of the hospitals complied with this standard. Two out of the seven hospitals did not have written procedures, while five had some written procedures that did not meet VA operating policies.
   
   
4. The VA's community care staff does not receive adequate health IT training, the report found. VA regulations require there be at least one week of training, and employees must complete 100 consecutive document scans without any errors. The audit found that all seven facilities were not complying with VA policies, and one of the locations required staff to conduct quality checks on scanned records.
   
   
5. In response to their findings, the OIG recommended the undersecretary for health ensure leaders provide training and quality assurance monitoring to health information management staff, as required by VA policy. The VA said on June 10 they are replacing the acting undersecretary with someone who has yet to be confirmed by Congress.