It seems everything that could go wrong with an EHR rollout did at the Ventura County Health Care Agency, a county-run healthcare system in Thousand Oaks, California. A grand jury investigation found the county neglected to plan, hire and adequately train for the transition.

Moreover, according to the report, dated May 29, 2014, VCHCA failed to procure laptops and servers in a timely way, significantly underestimating the total number of simultaneous users the EHR system had to accommodate, and it lacked a dedicated and experienced project manager to oversee, track and report all tasks.

VCHCA tapped Kansas City, Mo.- based Cerner for its EHR. The grand jury found that beginning with the Cerner contract in October 2011, the county lacked a project manager.

The lack of a project manager "contributed to staff being inadequately prepared for using the new system and to a problematic EHR system implementation by VCHCA," the grand jury concluded.

[See also: CEO resigns amid troubled EHR rollout.]

The rollout started July 1, 2013, and Cerner staff was onsite to help with the rollout for the first few weeks after implementation, according to the investigation.

The report notes that "user license requirements were underestimated by VCHCA leading to inadequate system capacity -- Cerner later provided additional licenses; training of the staff was insufficient leading to inexperience with components of the EHR early in its implementation."

[See also: Go-live gone wrong.]

By December 2013, Cerner released a major update to the EHR system, an update that, according to the grand jury, resolved about 200 issues with the VCHCA system.

VCHCA Director Barry Fisher took issue with the report, telling the Ventura County Star that it failed to examine improvements made since July 1, 2013. The newspaper quoted Fisher as saying: "Yes, we had some issues early on. Where we are at today is night and day from where we started."

The grand jury did not limit itself to pointing out how VCHCA was lacking, but also offered these recommendations for future projects:

• Institute a standard, PMI-recognized project management plan for capital projects, for example, a Gantt chart-type software program that includes a master work plan, tasks and statuses.
• Have an experienced, dedicated project manager in place throughout the life of capital projects.
• Allocate and incorporate the required time and resources to each project to ensure that all project software and hardware is purchased and is on site, tested and installed to support proper implementation.
• Provide the required time and funding for staff to attend the appropriate training for all projects that involve new systems and/or procedures.

Access the full report here.