Deficits with Metrics Following Implementation of the New Electronic Health Record at the Mann-Grandstaff VA Medical Center in Spokane, Washington

The Office of Inspector General (OIG) evaluated the availability and utilization of metrics more than a year after the Mann-Grandstaff VA Medical Center became the first facility to implement the new Electronic Health Record (EHR) system. The OIG determined that, one year after go-live, gaps existed between required and available metrics using new EHR data. The OIG learned that many quality, patient safety, and organizational performance metrics were unavailable, including metrics needed for hospital accreditation. Additionally, the OIG found that access metrics were largely unavailable. The OIG remains concerned that deficits in new EHR metrics may negatively affect organizational performance, quality and patient safety, and access to care. Challenges with the new EHR’s metrics included the following: Cerner failed to deliver metrics reports, new EHR’s metrics could not be assessed prior to go-live, utility was impaired, and training was deficient. VHA-generated metrics using new EHR data also created challenges. VHA resources were insufficient for generating new EHR metrics, VHA metrics using new EHR data were not validated and unavailable, and VHA changed the metrics required from the facility. The OIG determined that deficiencies related to the new EHR’s metrics and challenges with VHA-generated metrics using new EHR data impaired the facility’s access to and utilization of metrics. The OIG is concerned that further deployment of the new EHR in VHA without addressing the gap in metrics available to the facility will affect the facility and future sites’ ability to utilize metrics effectively. Accordingly, to address the gaps in metrics available to the facility and future sites, VA must resolve the factors identified by the OIG that affect the availability of metrics. The OIG made two recommendations to the Deputy Secretary regarding evaluating gaps in new EHR metrics and the factors affecting the availability of metrics and taking action as warranted.