After visiting VA clinic in Wenatchee, Kim Schrier warns new software hurting veterans’ care, straining health care providers

WASHINGTON – After visiting a Veterans Affairs clinic in Wenatchee, Rep. Kim Schrier warned the VA secretary on Wednesday new software has slowed down veterans’ health care and caused burnout among doctors and nurses since it was implemented a year ago.

The Wenatchee clinic is connected to Mann-Grandstaff VA Medical Center in Spokane, where the department began using a new electronic health record system, or EHR, in October 2020. The system is used to track patients’ health conditions, prescriptions and other important records, and also lets veterans schedule appointments and order prescription refills, but glitches have caused widespread problems over the past year.

In a letter to VA Secretary Denis McDonough, Schrier wrote that staff she met at the clinic Tuesday told her the new system has made it harder for them to provide timely care to veterans. Before she was elected to Congress in 2018, Schrier worked as a pediatrician and used an EHR made by the same company that is developing the VA system, Kansas City, Missouri-based Cerner Corp.

“I truly believe the doctors and nurses in Wenatchee are doing the best they can under challenging circumstances to care for Veterans, but their jobs have been made exponentially more difficult by the failed rollout of the Cerner health records system in the last year,” Schrier wrote. “One doctor told me she is able to see just half the number of patients each day now than one year ago due to inefficiencies and technology breakdowns under Cerner.”

Other clinics attached to Mann-Grandstaff in Coeur d’Alene, Sandpoint and Libby, Montana, also started using the new EHR last year. The rest of the nation’s VA facilities are still using an older system that works more smoothly, despite being outdated, according to doctors and nurses who have spoken with lawmakers and the VA’s own Office of Inspector General.

In an internal survey of 833 Mann-Grandstaff employees shared with staff Oct. 8 and obtained by The Spokesman-Review, 80.9% of employees said the new EHR had worsened their level of burnout and 62.5% said it had made them consider quitting. In an email in which he shared the survey results, Mann-Grandstaff Director Dr. Robert Fischer said employees had also reported 576 patient safety issues related to the new EHR.

In an event at the National Press Club in Washington, D.C., on Tuesday, McDonough thanked employees in Spokane for their “dedication to testing out this new capability and, importantly, informing us on how to improve it.”

“We are listening very closely to our personnel in Spokane, because of the fact that they’re on the front line of testing out this technology,” McDonough said in response to a question from The Spokesman-Review. “We’re also hearing very clearly their patient safety concerns and addressing those as we find them.”

In an interview Wednesday, Schrier said some amount of burnout is to be expected when a health care system transitions to a new EHR, but the degree of exhaustion staff in Wenatchee described to her is far from normal.

Employees at the clinic told her the Cerner system frequently crashes, Schrier said, forcing them to do extra work to retype lost notes and make sure patients’ records are correct. Staff also told her the new EHR has slowed down routine steps like measuring a patient’s height, weight and blood pressure before seeing a doctor.

Problems with the part of the system patients use to manage their prescriptions and schedule appointments have caused them to rely on calling the clinic, but the VA phone system is routinely overwhelmed and routes calls away from the Wenatchee clinic. Schrier suggested VA could hire veterans to answer those phones or implement a call-back system like many customer service lines use.

“They just want to be able to pick up a phone and speak to someone who can answer their questions and get them the help they need,” Schrier wrote to McDonough. “A system that leaves Veterans unable to reach their providers, especially during a public health emergency, is troubling.”

McDonough said Tuesday he won’t bring the Cerner EHR to other VA facilities until “the lessons that you’re providing us” are “implemented,” but Schrier said she wants to learn exactly what that would mean in practice and hopes the department is “willing to hit pause, or even rewind.”

“If they have to scrap this version of Cerner, it’s probably better to do that and use something that’s tried and true than to try to fix a system that is just broken from within,” she said.

VA Deputy Secretary Donald Remy told lawmakers Nov. 2 he plans to visit Mann-Grandstaff next week.