Background to Veteran’s Association EHRM program
An Electronic Health Record Modernization (EHRM) plan is currently being implemented in the United States over a ten-year period. The aim of EHRM is to make healthcare for veterans significantly more efficient. Prior to this plan the Electronic Health Record (EHR) system was nearing forty years in age, offering a poor interface and functionality relative to modern EHR systems implemented across the United States. Using this system, all veterans will have a comprehensive EHR equipped with their full medical history including ongoing treatment and medication, in addition to other key information regarding their health. Another important feature that EHRM will include, is a ‘veteran’s portal’. This can be used by veterans to renew their medical prescriptions and engage with their clinician in an easier manner than previously possible.
Harm caused to hundreds of veterans
In July 2022, an alarming discovery was reported regarding the new EHR system that has begun to be rolled out by Oracle Industries. The office of inspector general conducted a report on the ten-year plan and found multiple cases where harm may have been caused to veterans due to inadequacies in the new system. It was uncovered that on 149 occasions, minor harm was caused to veterans where a glitch occurred that hindered them from receiving notes from their clinician. Although the harm inflicted affected hundreds, tens of thousands of requests to receive clinical care went unfulfilled between a period of October 2020 and June 2021. The office of inspector general stated that these requests were sent to an unknown location or an unknown queue instead of the intended clinician. The queue was intentionally implemented to process requests that were unable to reach the intended clinician, however, a major flaw presented itself. The clinicians that could not receive the request for various possible reasons were not informed by the EHR that a request was put in that couldn’t reach them.
In February 2022, attempts were made by Oracle Cerner to amend this by updating their EHR with an alert when an order was made accompanied by a location that doesn’t match. A leading figure of VHA stated that this amendment had been unsuccessful in May 2022. The executive vice president of Oracle industries, Mike Sicilia, has stated at a recent hearing that ‘more is working than not’ in attempts to reassure veterans that the EHRM has been a success thus far. The executive vice president emphasized that the program will not go live until patient safety is fully secured and that the new system is a ‘top priority’ for the organization. Sicilia also mentioned that Oracle intends to improve many aspects of the EHR’s functionality to amend the queue dilemma. At present, the EHRM program has been paused until next year, when it is hoped that the modernized EHR will be rid of any safety risks.