Late Friday afternoon, the publication POLITICO published a report by Arthur Allen that reveals details of a Pentagon report on the Department of Defense (DoD) electronic health record (EHR) implementation project that experts who have seen it, say speaks to highly damaging issues with that rollout, problems that could impact the planned Veterans Administration Health (VA) implementation of a new EHR.
POLITICO reporter Arthur Allen wrote that “The first stage of a multibillion-dollar military-VA digital health program [EHR implementation] championed by Jared Kushner [in his White House role as director of the Office of American Innovation] has been riddled with problems so severe they could have led to patient deaths, according to a report obtained by POLITICO. The April 30 report,” Allen wrote, “expands upon the findings of a March  POLITICO story in which doctors and IT specialists expressed alarm about the software system, describing how clinicians at one of four pilot centers, Naval Station Bremerton, quit because they were terrified they might hurt patients, or even kill them. Experts who saw the Pentagon evaluation—it lists 156 ‘critical’ or ‘severe’ incident reports with the potential to result in patient deaths—characterized it as ‘devastating,’” Allen wrote on Friday, referencing the rollout of a commercial EHR at several naval bases. “Traditionally, if you have more than five [incident reports] at that high a level, the program has significant issues,” Allen quoted a member of the testing team as saying.
That DoD implementation involves a long backstory in itself. As Healthcare Informatics reported back in 2015, a team headed by the Kansas-City based EHR vendor Cerner Corp., and Reston, Va.-based Leidos, was awarded the massive Department of Defense Healthcare Management Systems Modernization (DHMSM) EHR contract, worth about $4.3 billion.
But this past January, DoD and Cerner said that they would be suspending the MHS Genesis modernization project for eight weeks. A NextGov report at the time noted that the pause in the EHR rollouts across DoD sites will allow those involved to “assesses the ‘successes and failures’ released to the field thus far. Meanwhile, Politico’s morning eHealth newsletter at that time also reported that there were currently “1,600 ‘open tickets’ from the early users of the system at four Washington state medical clinics and hospitals.” To this end, NextGov received word from a spokesperson for the Defense Healthcare Management System who said the DoD has actually received 17,000 “trouble tickets” from users at the four test sites, of which some 11,000 have already been addressed.
In October, Madigan Army Medical Center in Takoma, Wash. became the fourth military site to go live with the MHS Genesis EHR system. That deployment followed installations at Fairchild Air Force Base, Naval Health Clinic Oak Harbor and Naval Hospital Bremerton. Madigan was the largest and last of four Pacific Northwest bases that make up the initial phase of the multi-billion-dollar Cerner implementation.
Meanwhile, in his Friday afternoon report for POLITICO, Arthur Allen continued, “The project’s price tag and political sensitivity—it was designed to address nagging problems with military and veteran health care at a cost of about $20 billion over the next decade—means it is ‘just another ‘too big to fail’ program,’” according to a testing team member. “The end result everyone is familiar with — years and years of delays and many billions spent trying to fix the mess,” that team member added. What’s more, Allen wrote, “The unclassified findings could further delay a related VA contract with Cerner Corp., the digital health records company that began installing the military’s system in February 2017. The VA last year chose Cerner as its vendor, with the belief that sharing the same system would facilitate the exchange of health records when troops left the service. The military program, called MHS Genesis, was approved in 2015 under President Barack Obama. In a briefing with reporters late Friday, Pentagon officials said they had made many improvements to the pilot at four bases in the Pacific Northwest since the study team ended its review in November,” he added. One of the bases referred to is apparently Naval Station Kitsap (Naval Station Bremerton), in Washington state.
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