Monday, June 9, 2014

Grand Jury details errors in Ventura County’s EHR [Electronic Health Record System] implementation

June 4, 2014
iHealthBeat, published daily for the California HealthCare Foundation

A health system operated by California's Ventura County made several mistakes when implementing a new electronic health record system, according to a county Grand Jury report, the Ventura County Star reports (Kisken, Ventura County Star, 6/3).
The Ventura County Health Care Agency originally submitted a request for proposal for an EHR system in 2009. In 2010, the agency submitted another RFP calling for an integrated EHR system that would meet meaningful use criteria, such as electronic prescribing and health information exchange.
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments (Ventura County Grand Jury report, 5/29).
The EHR system went live on July 1, 2013, in two hospitals and 40 clinics in the county (Ventura County Star, 6/3).
Details of Report
The investigation included interviews with individuals involved in implementing the EHR system, as well as research into the American Recovery and Reinvestment Act of 2009.
The Grand Jury found that Cerner -- the selected bidder in the project -- recognized that VCHCA's resources were insufficient when implementing the EHR system (Ventura County Grand Jury report, 5/29).
Specifically, the Grand Jury found:
    Inefficient ordering of hardware required for the project;
    Insufficient staff to support the project;
    Insufficient staff training on the new system;
    No dedicated and experienced project manager to oversee implementation; and
    No standard project plan for implementation.
For example, the report found that the county sent 40 employees to Cerner for training after the vendor recommended that 120 employees undergo training (Ventura County Star, 6/3).
As a result, the report states, "There was a period of inefficient and delayed patient care" and billing processes were negatively affected (Ventura County Grand Jury report, 5/29).
The report recommended that the county develop better processes for capital projects.
County's Response
VCHCA Director Barry Fisher said the report was inaccurate and outdated because it did not examine improvements made since July 1, 2013.
Specifically, Fisher said an information technology specialist was hired as project manager a full year before the EHR system was implemented.
He said, "Yes we had some issues early on," but added, "Where we are at today is night and day from where we started" (Ventura County Star, 6/3).

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