VA Sprint Team Addresses EHR Governance, Patient Safety Issues
A March 2023 report about the work of a Department of Veterans Affairs (VA) EHR Modernization Sprint Project Team said the VA is streamlining its governance structure as well as making specific EHR changes to address specific patient safety concerns, including the management of clinical and administrative orders.
As the report explains, after acknowledging the VA’s implementation of the Cerner Government Services Inc. EHR has not met veteran or VAexpectations, in July 2022, the VA made the decision to delay deployment to the Boise VA MedicalCenter, promising to dig deeper into its readiness for deployments and address feedback from front-line users – resulting in the Oct. 13, 2022,announcementthat the VA would delay upcoming deployments until June 2023, while it underwent anaggressive “assess & address” period to diagnose and fix problems.In 2022, it became more and more evident, the report states, “that our structure and our processes were not optimal for successful deployments or to fix issues identified after deployments. Furthermore, it was evident that there was still much work to be done to standardize processes across VA and to continually optimize the new record for use in VA.”
To address the issues, VA leadership established the EHRM Sprint Project Team, acollaborative, multidisciplinary, enterprise-wide team to assess what needed to be fixed before the project went live again and ensure that deployments are successful going forward.Based on the report, the VA is implementing changes in its structure for decision-making and the processes for “go-live” decisions. The Sprint Team designed and established rapid decision-making bodies and processes within VHA to determine and prioritize key functional requirements of the system.
The report also recommended specific solutions to issues critical to patient care, for example:
• Accuracy, enterprise standardization, and reliability of data collected for upload to the new system in Data Collection Workbooks. This includes extra checks to ensure that the right data is uploaded.• Management of clinical and administrative orders. This includes ensuring that when a VA employee needs to place an order for a veteran, they can easily find the right order and it goes where it needs to go.• Standardization of EHR Naming conventions, including for locations, to ease cognitive burden and better support VA’s enterprise scale.
Some of the solutions are already completed, the report notes. In other cases, durable solutions may take many months, so the VA is pursuing interim solutions. “We will continue to implement the team’s recommended solutions to ensure that we are fully ready for the next deployment.”
