Becker's Hospital Review

47 CIO / HEALTH IT OIG: Cerner provided poor training, different EHR version in its $16B rollout at VA medical center By Hannah Mitchell I nsufficient training at the Spokane, Wash.-based Mann-Grandstaff VA Medical Center hampered the Cerner EHR rollout, according to a July 8 report by the Office of Inspector General. e Department of Veterans Affairs is supposed to approve Cerner's development of training plans and materials that the EHR vendor ex- ecutes and provides to VA staff. Cerner is supposed to provide train- ing coaches, and the VA is supposed to have staff trained as super-us- ers to provide assistance during the rollout. EHR training is supposed to be spread out over six weeks. e report found that Cerner and the VA did not give staff adequate training. Eight things to know: 1. e OIG found that the VA did not approve Cerner's training content or training delivery. Mann-Grandstaff leaders said training did not provide opportunities to test proficiency in various clini- cal scenarios. Instead, staff reported they were just learning which buttons to use without having context for what they were doing, the report said. 2. e OIG found significant gaps in training for business and clin- ical workflows, the report said. Four main causes for training gaps were listed as insufficient time for training, limitations with the training domain, challenges with user role assignments and gaps in training support. 3. Cerner said the training domain was a close copy of its new EHR version, but the OIG said Cerner's current EHR offerings did not closely match the VA's version. Giving the VA a different version hindered VA staff 's ability to utilize the EHR, the report said. 4. e OIG found that the VA is supposed to complete ongoing assessments of Cerner's work on training. e VA frequently identi- fied "recurring deficits in meeting project deadlines, staffing, man- agement and quality of products" while working with Cerner, the re- port said. Despite consistently reporting deficiencies with Cerner, the VA's contracting officials scored Cerner's performance as satisfactory, the minimum level required to keep from breaking the contract. 5. As a result of these problems, the VA Office of Electronic Health Record Modernization's director of change management, a Cern- er counterpart and a Cerner executive had frequent meetings that continued at the time of the OIG's inspection. 6. Although the director of change management said there were "actions taken to address Cerner's inadequate performance with training, the OIG was not able to confirm whether those actions led to substantive changes in contractor performance given that Cern- er continues to work on training through a no-cost extension to the contract," the report said. 7. "Disturbingly, leaders from VA OEHRM Change Management withheld some training evaluation data requested by the OIG and al- tered other data prior to sending to the OIG," the report said. "e in- tegrity and thoroughness of information provided by VA is required by law and is critical to the OIG's mission. e OIG has notified VA senior leaders of this issue and is further pursuing the matter. Be- cause the OIG was not provided complete information as requested, end user's training experience as outlined in the VA OEHRM training evaluation plan could not be fully evaluated." 8. "Cerner is fully supporting [the] VA and shares their commitment to getting this right," Brian Sandager, general manager and senior vice president of Cerner Government Services told Becker's. "Together, Cerner and [the] VA have made progress toward achieving a lifetime of seamless care for our nation's Veterans and we look forward to con- tinuing this important mission." n Amazon launches AWS for Health: 5 things to know By Hannah Mitchell A mazon launched Amazon Web Services for Health to offer curated offerings for thousands of health- care and life sciences customers worldwide. Five details: 1. The initiative will offer cloud-based solutions for 16 areas in healthcare, such as genomics, biopharma and patient-facing care, according to a July 15 news release. 2. AWS for Health will assist customers in creating holis- tic EHRs for clinicians to accelerate research and create data-driven care plans. 3. Amazon said the initiative will help health systems decrease their operational costs, improve interoperabil- ity and enable data-driven decision-making. For exam- ple, Wellforce will save as much as 20 percent annually, estimated at $3 million, by moving its operations to the cloud. 4. The initiative will have specialized programs for health IT, patient and clinician experience, billing, medical re- search, and more, the release said. In health IT, AWS will allow IT professionals to deploy machine-learning tools to gain insight into their health data. For clinicians, voice-to-text solutions help mitigate clinician burn- out and give providers and patients access to virtual care options. 5. Amazon Web Services on July 15 launched general availability of its new data lake service for healthcare providers and life sciences organizations, with Chica- go-based Rush University Medical Center among the first customers. n

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