[Ed. note: This story has been updated with a response from VA representatives.]

Rep. Matt Rosendale, R-Mont., asked the Department of Veterans Affairs and Cerner leadership on Friday to put in place a "true" bidirectional interface between Cerner's electronic health record and its pharmacy module.

Calling it "the single greatest technical problem with the Cerner EHR," Rosendale urged the VA to issue the EHR vendor contractual direction to address the issue.  

"Pharmacists at the Mann-Grandstaff VA Medical Center, the Jonathan M. Wainwright VA Medical Center and any subsequent sites will struggle with a needlessly complicated, time-consuming, error-prone, double-entry process to prescribe medication that saps productivity and puts veterans at risk," said Rosendale.  

As ranking member of the House Committee on Veterans' Affairs Subcommittee on Technology Modernization, Rosendale addressed the letter to VA Deputy Secretary Donald Remy and Cerner Government Services President Travis Dalton, FCW reported.   

Cerner directed Healthcare IT News to VA in response to requests for comment. 

“We have received Rep. Rosendale’s letter and will respond appropriately," said VA representatives after press time. "VA will continue to direct Cerner to address issues and concerns raised by leadership and staff at sites where the electronic health record system has been deployed and will incorporate lessons learned as VA prepares to move forward with future deployments."

WHY IT MATTERS  

According to Rosendale, the issue lies with the interface between PowerChart and Cerner's pharmacy module, Medication Manager Retail.  

Although Rosendale did not include specifics about the problems users are allegedly encountering – and did not respond to follow-up requests for details – the Office of Inspector General flagged medication management as the subject of several complaints from Mann-Grandstaff staff in a report released this past month.  

Such complaints included concerns around data migration, medication orders and medication reconciliation.

That report spanned January 2021 through June 2021. At the time of its release, Dr. Terry Adirim, the program executive director of VA's Electronic Health Record Modernization Integration Office, told the Washington Post that the agency has made "a substantial number of changes."

Rosendale, for his part, said that although the EHR Modernization Integration Office had identified the interface as a priority at least two months ago, "it appears that no action has been taken."  

"It is my understanding that such a project to write and test EHR code would typically take Cerner roughly two years," said Rosendale. "This must be accelerated."  

THE LARGER TREND  

Just a few days before Rosendale wrote his letter, dozens of federal sites using Cerner's EHR system went down, leading to nearly three hours in which clinicians couldn't update medical information.  

"Federal clients of the new Cerner electronic health record system (VA, Department of Defense and U.S. Coast Guard) experienced a system outage from 4:09 p.m. to 6:15 p.m. CT on April 6, 2022," VA representatives told Healthcare IT News.

"The system was not accessible to end users during this time and sites entered downtime procedures, [including] going to paper charting until the system was turned back on," they continued. The incident followed an outage at the beginning of March that may have affected the records of more than 200 veterans.

ON THE RECORD  

"I encourage you to defer any potential disputes over financial responsibility in order to proceed with the work," said Rosendale in his letter. "The Electronic Health Record Modernization program is already perilously behind in addressing this problem, and knowingly spreading it to other medical centers' pharmacies would be irresponsible."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.