WASHINGTON – On the morning of July 13, health care providers at Mann-Grandstaff VA Medical Center in Spokane were greeted by a familiar message in their inboxes.
Because of a “significant degradation” in the electronic health record system they rely on to do their jobs, the email said, clinicians who couldn’t use the computer system should follow a “downtime contingency plan.”
After more than 18 months serving as de facto beta testers for the troubled system, for which the Department of Veterans Affairs is paying Cerner Corp. at least $10 billion, VA employees in Spokane knew exactly what the email meant. Instead of using the computer system to track patient information and order prescriptions and follow-up care, they would need to document everything on paper.
“It basically just shuts everything down to a crawl,” said Gary Bilendy, an urgent care nurse at Mann-Grandstaff who has experienced dozens of similar Cerner degradations. “You just can’t function that way. Somebody’s going to slip through the cracks.”
In response to questions from The Spokesman-Review, VA Press Secretary Terrence Hayes said there had been a total of 24 outages and 48 “performance degradation events” in the Cerner system since it was launched at Mann-Grandstaff and its affiliated clinics across the Inland Northwest in October 2020.
But a document obtained by The Spokesman-Review suggests those numbers underestimate the true frequency of disruptions in the system. The document includes more than 180 incidents classified as degradations, “downtime” and full or partial outages that have affected the system’s users just since September 2021.
Problems with the Cerner system have risked veterans’ safety and left health care workers exhausted and demoralized. A report published Friday by the VA Office of Inspector General revealed a feature of the system caused long delays in care when referral orders were effectively lost, resulting in 149 cases of harm.
After The Spokesman-Review obtained a draft of that report, the VA announced June 18 it would delay the system’s launch at facilities in Western Washington from August until March 2023. But despite the VA concluding the system does not have “adequate reliability” to be deployed around Puget Sound, it continues to be used at facilities serving tens of thousands of veterans in Washington, Idaho, Oregon and Ohio and is scheduled to launch in Boise on Saturday.
While poor training and flaws in the system have caused problems even when it is up and running, VA officials have admitted the system has been partly or completely unusable dozens of times since it was launched.
In May, the top VA official in charge of the system’s rollout, Terry Adirim, told The Spokesman-Review there had been nine “unplanned outages” and 42 “unplanned degradations” as of April 20.
Adirim defined an outage as an “unscheduled event where a clinician is unable to use the electronic health record because the entire system is down.” A degradation is “when all systems and applications are available, but all clinicians experience a similar issue, including the system running slower than normal.”
Other incidents that don’t meet those definitions – including “system errors, latency and application incomplete functionality” while “portions of it were still working” – were not included in those numbers, Adirim said in a statement at the time.
Hayes, the VA press secretary, did not give different definitions to explain why the numbers he provided as of July 6 – 24 outages and 48 degradations – were so much higher than the figures Adirim revealed in May. Most of the problems have occurred since September 2021, Hayes said in a statement: 20 outages and 29 degradations.
Of the 24 outages, Hayes said 22 were caused by a component or system belonging to Cerner and two were caused by the Department of Defense, which is implementing a similar…
Read More: Internal document reveals more frequent computer problems at Spokane VA than