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An electronic health records system for veterans has caused unnecessary suffering


It took decades for the Department of Veterans Affairs to begin updating its electronic health record system. Now, billions of dollars later, the VA has halted that update after multiple breakdowns and four deaths connected to system errors. It abruptly stopped all work on its $16 billion rollout of the Oracle Cerner electronic health system. It had been introduced at only five VA sites. NPR's Quil Lawrence spoke to some of the vets affected.

CHARLIE BOURG: Well, I had gone to my doctor's office for another yearly appointment, I believe.

QUIL LAWRENCE, BYLINE: Charlie Bourg is a Vietnam vet living north of Spokane, Wash. He noticed his VA doctor was having trouble with the new program.

BOURG: She tried to put in the referral to urology, and it took her three times to get it in. And at that time she goes, got it this time. So she told me that they would contact me when urology got the results if they needed to see me.

LAWRENCE: Bourg never heard back. Months later, he saw his primary doc again. She asked why he'd never gone to the urologist. He finally saw one 10 months after the original referral.

BOURG: And at that time, they found out there was, I believe, a tumor on my prostate. And it came back that the cancer had spread to my lymph nodes between my spine and my stomach where they couldn't get to it. And that's why it's terminal.

LAWRENCE: Bourg says it might have been treatable, but his referral had disappeared into a glitch in the system. On top of the emotions he's feeling, the grief for his family, his grandchildren, Bourg resents that veterans in Spokane and four other sites have had to deal with the troubled Cerner program.

BOURG: I was kind of irritated because, basically, they'd used us as guinea pigs on a system that they had never tested, and Cerner was saying it was OK.

LAWRENCE: The Department of Veterans Affairs pioneered electronic health records with a program called VistA back in the 1990s. The decades-long push to update VistA and make it compatible with the Pentagon's health system wrapped up in 2017 when the Trump administration bought the Cerner system for $10 billion over 10 years in a no-bid contract. But so far, it's only rolled out in five sites, including Spokane.


PATTY MURRAY: The rollout at VA sites at Washington state has been an ongoing disaster with new disruptions still happening.

LAWRENCE: That's Washington Senator Patty Murray talking at a hearing last week on VA spending.


MURRAY: I've heard from providers who are burnt out trying to navigate this broken interface, patients who were unable to get medicine they rely on because of system malfunctions and even a patient who received a late cancer diagnosis because of flaws in the system. And that's just what we know right now. It is unacceptable.

LAWRENCE: VA Secretary Denis McDonough didn't contradict her. The Oracle Cerner system has been blamed for at least four deaths and hundreds of other harmful errors. McDonough has paused the rollout twice in the past year.


DENIS MCDONOUGH: I am extraordinarily frustrated with this. I know our providers and our veterans in Washington and in Oregon and in Ohio are extraordinarily frustrated with this.

LAWRENCE: Finally, late last month, VA announced it would halt all further deployments of the system. McDonough says VA will concentrate on the five sites where Cerner is running and try to fix it.


MCDONOUGH: The whole point of this reset is clear away everything else. Let's focus on the five. Let's get it right. And then we'll talk about onward deployment.

LAWRENCE: That's not good enough for many of the vets and providers using the system. Ed Meagher, a former VA official, says the Cerner deal needs to be dumped.

ED MEAGHER: No matter how many billions of dollars they spend at it, they cannot make this system perform as well as their current system. I think they're simply grudgingly admitting that this isn't going to work.

LAWRENCE: Meagher thinks the VA's old VistA system can be updated and work better, and it's wrong to keep subjecting vets at those five sites to a flawed system.

MEAGHER: For making them be guinea pigs in the first place but to continue it now. And they've been willing to accept four deaths as the price of putting a system in place. You cannot do this to people. You cannot do this to veterans. This is health care. This is life and death.

LAWRENCE: There's a five-year option to renegotiate the Oracle Cerner contract. That comes up later this month. And VA officials say they're pushing hard for better service. Otherwise, many in Congress are suggesting the VA should walk away. Quil Lawrence, NPR News. Transcript provided by NPR, Copyright NPR.

Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.
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