“FEDERAL NEWS NETWORK”
“The departments of Defense and Veterans Affairs still have a very long way to go before they achieve the long-sought objective of a fully integrated electronic health record infrastructure.
But a pair of recently released oversight reports show that the multibillion dollar EHR programs, both of which had rocky starts, have made meaningful progress in just the past year.“
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“The Department of Veterans Affairs delayed its initial rollout of the Cerner Millenium EHR suite twice last year — once to allow for more training, and then because of COVID-19. But the department managed to complete its first deployment, in Spokane, Washington, in October.
But before that, VA spent the prior four months squashing bugs that could have derailed that deployment. According to a Government Accountability Office report released late last week, tests as of June 2020 showed VA’s Cerner implementation had 530 “high severity” findings and 29 “critical” ones. By the time of the October deployment, it was down to zero critical issues and 55 high severity findings. And VA had found acceptable workarounds for 47 of them.
GAO cautioned that VA is sure to find more problems as it conducts more testing and deploys the EHR to its next site, the larger Puget Sound medical center in Seattle sometime between July and September of this year. But the initial results are encouraging. The watchdog did say, however, that the department should put any more deployments on hold until all those high severity findings are resolved.
Meanwhile, the Pentagon’s office of the Director of Operational Test and Evaluation (DOT&E), which has been harshly critical of DoD’s version of the EHR, also found a few positive things to say in this year’s annual report.
The first round of operational tests on the system, in 2018, found it was neither “operationally effective nor operationally suitable.” As of the latest report, DOT&E deems the system, known as MHS Genesis, operationally effective for basic clinical operations. It’s still not met that threshold for specialty care, but progress is progress. Meanwhile, overall system usability has improved from “unacceptable” to “marginal-low,” according to DOT&E.
And the department has gone some way toward improving Genesis’s cyber posture, which the office previously assessed as “not survivable” in a contested cyber environment. Starting in August, the Defense Health Agency stood up a permanent team to simulate persistent, real-world cyber threats against Genesis to continuously tests the system’s defenses.
“The innovative program will assess the cyber posture of MHS Genesis and the effectiveness of network tools, cyber defense tools, and cyber defender processes, and is one of the best ways to improve the program’s defenses against nation state-level threats,” according to the report.
In September, DoD deployed Genesis to its latest round of 10 hospitals and clinics in California and Nevada, in a part of the phased rollout known as “Wave Nellis.” And to be clear, DOT&E believes the system still has a very long way to go. Overall, testers believe Genesis is still not operationally suitable, partly because of insufficient training and usability problems.
But like VA, DoD does seem to be solving new problems as they appear during the rollout process – even if the pace of those fixes is slower than clinicians and patients might like. Eighty percent of the problems identified during initial testing at the first hospital rollout have been solved, a feat that even DOT&E terms a “significant achievement.”
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