healthcarereimagined

By Darius Tahir | 03/08/2018 10:00 AM EDT

With help from Arthur Allen (@arthurallen202) and Mohana Ravindranath (@ravindranize)

DoD CERNER INSTALL IS BROKE SO FAR: The Department of Defense’s Cerner installation is broken badly so far, our colleague Arthur Allen reports. Physicians at the four northwestern military sites at which the Cerner EHR is being installed are complaining of kludgy systems and long log in times. And while it’s difficult to precisely attribute any one adverse event to a specific software problem, Patient Safety Reports – which are required whenever a life- or limb-threatening medical error is discovered – were “being filed almost every day” in the first few months, said one physician at Bremerton.

“The bottom line is … the Cerner user build is immature and needs to be brought up to a functional level,” another doctor said. “There were some expectations at higher levels that this … was an out-of-the-box solution that would work perfectly, but it didn’t.”

Cerner and Leidos say the problems are temporary speedbumps; meanwhile, Jared Kushner was selling the program in sparkling terms a couple days back at HIMSS. Pros can get the rest here.

STRUGGLES AT VA CONTINUE: Meanwhile, the other part of the Cerner installation train – the Department of Veterans Affairs – is mucking around in the slop. Wednesday, another report from the department’s Office of the Inspector General faulted the agency – this time for “critical deficiencies” in the Washington, D.C., VA Medical Center.

While the most worrying allegations didn’t concern IT matters – the report said that some ostensibly clean areas were not – the center was sloppy in handling private health care information. It said 1,307 boxes were left unsecured and improperly stored, leading OIG to take possession of the records; 1,058 of those boxes housed private health information, including “individual patient pulmonary function studies, veterans’ identification cards, patient health records and films, as well as personnel and other administrative documents.”

Meanwhile, whispers that VA Secretary David Shulkin is not long for the job continue to brew; a Daily Beast report argues that his days are numbered, in an unspecified way.

All these struggles – ranging from real-life failings to more evanescent chatter – are swirling while the agency tries to complete its $10 billion acquisition of a Cerner EHR. At a Wednesday House Veterans Affairs’ Oversight and Investigations Subcommittee hearing, the timeline on that got no clearer.

Rep. Ann McLane Kuster, the subcommittee’s ranking member of the subcommittee, said she believed Shulkin would sign the Cerner contract by the end of the month. But Fred Mingo, director of program control at the VA’s Electronic Health Record Modernization Program, said he was “as anxious as anyone in this room to hear an award date,” while demurring on when Shulkin would put pen to paper. Mingo also wasn’t able to explain why the contract had yet to be signed, saying there were two issues – before catching himself and saying he’d submit the answer later, for the record.

Shulkin himself enjoyed the support of one of the witnesses from veterans’ organizations. The American Legion’s Louis Celli Jr. declared that the “Secretary [is] under fire by ideologues” at a time when he needed the support to begin the mammoth task of converting the VA to a new electronic health record.

The hearing had an official subject: consideration of a few reform bills. Two of them directly concern health IT matters: the first (H.R. 3497 (115)), sponsored by Rep. Cathy McMorris Rodgers, would support a pilot project to give veterans a gadget that would store – and allow them access to – their medical records. That bill was opposed by the VA, and split the witnesses from the veterans organizations present.

The second bill, the Veterans EHR Modernization Oversight Act of 2017 (H.R. 4245 (115)), requires the VA to submit documents and update Congress about the progress of its EHR project.