A government watchdog has flagged issues with the Veterans Affairs Department's new scheduling platform, which is part of a multibillion dollar effort to modernize the agency's electronic health records system.
The new system, built by Cerner as part of a $10 billion contract, was launched at two facilities in Washington state and Ohio last year despite knowledge at the VA of "significant" system and process limitations, the VA Office of Inspector General stated in a report released Thursday.
"These limitations reduced the system's effectiveness and risked delays in patient care," reads the report.
The modernizing effort was launched last year to provide veterans a comprehensive health record built on the system used by the Defense Department.
Part of that project aims to make it easier for veterans to schedule appointments for care, replacing a system that has been used by VA medical facilities since the 1980s.
The Veterans Health Administration, the Office of Electronic Health Record Modernization and Cerner were responsible for implementing the scheduling system, and Cerner trained schedulers and providers to use it.
While the OEHRM was aware of performance issues due to assessments that occurred between November 2018 and July 2020, they were not fully resolved before the system went live in Columbus, according to the report.
Schedulers had issues changing the appointment type and would need to manually create a new one or ask the provider to submit a new order, according to OIG.
They were also unable to mail appointment letter reminders automatically, which the old system allowed, and the new system lacks oversight reports formerly available to track and monitor patient wait times.
OIG stated that VA leaders did not provide scheduling staff with enough opportunity to identify limitations in the new system before implementation.
More issues arose after the new system was implemented in Columbus but they weren't resolved before it went live in Spokane, OIG said.
The system was missing information for some clinics, appointment types and providers, and some schedulers didn't have the ability to schedule appointments.
Data from VHA's old system were not accurately or completely transferred to new the new scheduling system when deployed at Columbus and Spokane, according to the report, and automatic appointment calls provided misleading information and needed to be turned off.
"Facility staff said it generally took more than a week for Cerner to close help tickets, unnecessarily delaying some patients' care," the OIG report reads.
The OIG wrote in its report that the VA lacked a mechanism to assess whether Cerner was complying with its contract's timeliness requirements.
The OIG recommended the VA resolve the issues "as soon as possible, ideally before deploying any more of the new EHR system at future facilities."
The VA had planned to fully implement the new scheduling system at all facilities by December, but future deployments were paused in March while a strategic review of the full program is conducted.
The OIG recommended that the VA improve training for scheduling, better engage schedulers in testing and improvements, issue guidance on measuring patient wait times in the new system, track help tickets consistent with Cerner contract terms, develop a strategy to promptly resolve issues and evaluate patient care timeliness.
The VA agreed with the recommendations.
In a written statement to Modern Healthcare, Brian Sandager, general manager of senior vice president of Cerner Government Services said it is implementing changes as directed by the VA.
"Cerner takes our responsibility to Veterans and VA providers seriously. The new system should aid VA staff to improve access to care for Veterans," Sandager said.
"The report noted schedulers praised the system for being more user friendly and highlighted the ease of scheduling video visits. We remain engaged on-site in Spokane and Columbus gathering feedback and implementing changes as directed by VA. It's important to get this right and we remain committed to this mission," he said.
