Wenatchee World: Schrier raises alarm after VA watchdog warns Spokane hospital risks losing accreditation due to data reporting problems

June 7, 2022 – WASHINGTON, D.C. — After a watchdog report found Spokane’s VA medical center has failed to collect and report data needed to improve patient safety and maintain the hospital’s accreditation since launching a new computer system in October 2020, a Washington congresswoman called for the Department of Veterans Affairs to fix the system before it causes an exodus of medical staff.

The report from the VA Office of Inspector General, released June 1, found Mann-Grandstaff VA Medical Center in Spokane lacked important metrics a year after it became the pilot site for an electronic health record system that has caused a range of problems for veterans and VA employees around the Inland Northwest.

Rep. Kim Schrier, a Democrat whose district includes a clinic in Wenatchee that is connected to the Spokane hospital, said in an interview Monday the report reinforced what she had already heard from employees at the clinic and the veterans they serve.

“When you can’t get good data in, you can’t get good data out,” said Schrier. “Mann-Grandstaff and the associated clinics, they can’t get any of the metrics they need to see how their veterans are doing and to improve their processes, and it’s all related to the same thing, the electronic health record.”

Health care workers rely on electronic health record systems to keep track of patient information and make their work safer and more efficient. While VA’s existing system remains popular with its users, in 2017 the department signed a $10 billion contract with Cerner Corp. to adopt a system similar to the one used by the Department of Defense in its medical facilities. Watchdog agencies have estimated the total cost of the effort could exceed $21 billion.

Noting that VA has called data about its facilities a “critical resource,” the report details how employees in Spokane had to do a “tremendous” amount of additional work to manually compile reports that should have been produced by the system itself. Of 103 performance metrics the department relies on to monitor the quality of care at its hospitals, only 13 were available from the Cerner system, according to the report.

Some of those metrics are required by the Joint Commission, a nonprofit organization that monitors and accredits U.S. hospitals, but 17 of the required metrics could not be produced by the new system and a VA employee told the Office of Inspector General that Mann-Grandstaff was “absolutely not” ready for an accreditation survey.

The gaps in those statistics, the report found, “impaired the facility’s ability to measure and act on issues of organizational performance, quality and patient safety, and access to care.”

Schrier, who worked as a pediatrician before entering Congress, said she has used a similar Cerner system and while she expects any transition to a new electronic health record to be frustrating at times, the experience at Mann-Grandstaff and the Wenatchee clinic has been unacceptably bad.

“You go through growing pains when you adopt a medical record, but you shouldn’t have this,” she said. “Listen to the staff about whether they’re able to perform their duties, whether they’re able to see the regular number of patients, whether the computer keeps crashing.”

VA officials have acknowledged that the Cerner system has been partly or totally unusable at least 50 times since it launched in Spokane, with slowdowns and other problems occurring frequently.

Mann-Grandstaff and its associated clinics in Wenatchee, Coeur d’Alene, Sandpoint and Libby, Montana, served more than 35,000 patients in the fiscal year from October 2020 through September 2021, the report said.

Schrier, citing an internal survey in 2021 that found nearly two-thirds of Mann-Grandstaff employees considered quitting because of the system, said the VA may need to consider switching back to the old system — which is still used at nearly all VA facilities — until the problems are actually solved.

“When you hear morale is low, you’ve got to do something to help or you’re going to lose all your staff, and then our veterans lose care,” Schrier said. “This is the time to listen to staff and figure out what needs to change immediately. Maybe they need to rewind, go backwards to the old system until they get this figured out, just to make people’s jobs at least go back to what they were beforehand.”