VA provides ‘insufficient’ training on electronic health records, IG warns


Written by Jackson Barnett

The Department of Veterans Affairs is not providing sufficient training to medical staff on the new electronic health record systems it is deploying across the country, the inspector general found in a new report.

Lack of training has prevented clinicians from using the system the way it was designed, according to the report. The new computer system is part of the VA’s $ 16 billion Electronic Health Records Modernization Program first launched at Mann-Grandstaff’s facility in Spokane, Washington. The deployment was hampered by a series of issues, several delays due to training issue and low test warnings. The program was put on hold while it underwent a “strategic review” by the new secretary.

In a separate report, the IG found that VA underestimated the costs associated with upgrading the IT infrastructure that will support the new EHR system, by up to $ 2.5 billion. The cost overruns could bring further Congressional scrutiny to a program already under the microscopes of lawmakers.

“During this review, the OIG found that VA OEHRM failed in that the approved program had significant deficiencies in the content of the training, the delivery of the training and its ability to assess the effectiveness of the training provided. “, says the report.

The training software provided to staff doesn’t look much like the end product being rolled out, the IG found. The gap alone would have caused confusion even if the training had gone smoothly, but its execution was sloppy by assigning users to training that did not match their job. The training focused on specific tasks and not on the many clinical scenarios that Mann-Grandstaff staff must respond to, processes called “workflows” in the report.

“Facility staff reported a lack of workflow training content and associated reference materials that prevented them from not only understanding how to apply the little they learned to their day-to-day work, but also to have a basic understanding of the meaning of workflow processes, ”the report stated.

The report found that the establishment’s leaders coined the term “button-ology” to refer to training because it only provided information on which button to press and now how to use the technology in world scenarios. real.

The ineffective training led staff members to have a lack of confidence in the system, according to a survey included in the report. A majority of users said they didn’t feel they could navigate apps, access or share patient information easily, or that they had the ability to document patient care in the new system. Only 5% of users answered positively to all four questions, according to the survey result.

“Overall, the survey results showed that after training and two to three months of re-using the EHR, only a small percentage of facility users reported easy use of basic EHR functions.” , indicates the report.

The training issues come as more reports of cost overruns question whether the VA will need to request more money to support the system’s nationwide rollout. The IT infrastructure upgrades for the DSE system were initially expected to cost $ 4.3 billion, which could be as much as $ 2.5 billion less.

One of the challenges in understanding how much the EHR system will cost is that the money is split between general office IT infrastructure upgrades and those specific to the EHR system. The VA is required to file reports to Congress on the costs associated with the EHR program,

“[T]there were inadequate procedures for determining whether an update of the cost estimate is required in the reports commissioned by the congressional office, ”the report said.

Another recent report pointed out similar problems with physical infrastructure cost estimates. The secretary also noted in recent congressional testimony that costs could rise if the VA were to increase additional resources for each medical facility that gets the EHR system, as the department had to do at Mann-Grandstaff.

“It seems to require a lot more people on target in Spokane,” he told the House of Veterans. commission in March.

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