Media Report: Medical Errors Reported during Banner Health’s Switch to Cerner EHR

After Phoenix-based Banner Health implemented a new Cerner electronic health record (EHR) at its Tucson, Arizona-based hospitals and clinics back in October, at a price tag of $45 million, there were “numerous” reports of medical errors, according to a state report obtained and reported on by the Arizona Daily Star.

In an article published Monday, Arizona Daily Star reporter Stephanie Innes reports that records of an Arizona Department of Health Services investigation into complaints about Banner’s EHR conversion indicate Banner’s Oct. 1 switch from Epic to Cerner “adversely affected patients and caused a high level of frustration among some staff members,” according to the article.

The Epic-to-Cerner switch followed Banner Health’s acquisition of the University of Arizona Health Network in 2015. Two years prior to its sale, the UA Health Network completed a $115-million Epic implementation.

According to the Star, citing a heavily redacted report, an October 19 complaint stated, “The biggest issue is patient safety and harm to patients,” and that “many of the staff are in tears and frustrated because of the lack of support and empathy to the consequences of patient care.”

Hospital leaders acknowledged delays in getting patients registered, delays in ordering and receiving lab results and delays in ordering and getting medications, records say, but said no patients were harmed, Innes reported.

“Hospital leadership denied there were any incidents that resulted in a negative outcome to patients, however, the hospital’s occurrence log for October 2017 showed numerous incidents of medical errors reported to be a result of the conversion,” state investigators wrote, as cited by Innes in the article.

The article reports, citing the investigation records, that the Arizona Department of Health Services did not fine or cite Banner. Banner took “sufficient corrective action” for issues raised in two substantiated allegations about the conversion, records show.

According to the article, state records indicate that the two substantiated allegations were connected to two October complaints about “the inability to reliably deliver medications, order tests and care for critically ill patients,” and “multiple computer/printer glitches” impacting patient care.

Banner Health officials declined an interview with the Star regarding the issue, but the health system said in separate emails that more than 100 improvements to the new Cerner electronic health records system have been implemented this year to streamline workflows and provide better access to information for physicians and staff.

“These changes include dramatic improvements in medications processing and pharmacy; improved administrative operations in our oncology department; and rapid and enhanced access to patient records for our clinical staff; to name a few,” one emailed statement to the Star reads.

The statement also read, “Along the way, we did experience challenges, some of which were significant. However, we are proud of the progress we have made, will continue to refine our systems and technology, and are more committed than ever to making sure the Banner experience is world class.”

“Banner’s conversion to Cerner in Tucson ultimately will allow for advanced clinical research with a large data set, benchmarking of clinical performance, improved quality, patient safety and a better patient experience, Banner officials say,” according to the Star article.

Banner Health senior executive leaders also are facing another significant IT issue—the federal government is investigating the health system’s IT security following the massive 2016 cyber attack that compromised the personal information of 3.7 million individuals.

An Ernst & Young 2017 year-end financial report on Banner Health notes that the health system has been the subject of an investigation by the Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS).

“The OCR investigation is still active, and the OCR has indicated that the initial Banner responses with respect to its past security assessment activities are inadequate. Although Banner has supplemented its initial responses, Banner anticipates that it may receive negative findings with respect to its information technology security program, and that a fine may be assessed against Banner. At this point, it is not possible to estimate the range of potential fines by the OCR,” that report states.

That security incident was initiated on June 17, 2016, and was discovered by Banner in late June 2016. Banner computer systems that process credit card payments in food and beverage outlets at certain Banner locations were accessed by unauthorized persons. The attackers targeted payment card data, including cardholder name, card number, expiration date and internal verification code, as the data was being routed through affected payment processing systems.

Then, in July, Banner Health learned that the cyber attackers may have indeed gained unauthorized access to patient information, health plan member and beneficiary information, as well as information about physician and healthcare providers.

Banner Health also is facing a class action lawsuit filed in August 2016 on behalf of the 3.7 million individuals affected by the data breach. The plaintiffs, including a former ophthalmologist at Banner Thunderbird Hospital in Glendale, Arizona, alleged the health system failed “to take adequate precautions” like multi-factor authentication, firewalls and encryption.