250,000 VA Patients Are At Risk Of Receiving Wrong Medication Due To Electronic Health Records Issue

About 250,000 veterans may be prescribed prescription drugs that they have allergies or interact poorly with their existing medications because of problems with the Department of Veterans Affairs' new electronic medical records system, a veterans watchdog group said. Thursday

A VA official who testified at the same hearing said the department emphasized that patients were not identifying drug interactions specifically because of data problems.

But at least one veteran did not receive the medications he was prescribed because the records were inaccurate and the Veterans Administration did not adequately notify patients that prescription records could be incorrect, according to the Veterans Affairs watchdog.

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“We remain concerned that patients are not being informed of their injuries,” VA Deputy Inspector General David Case said at a Thursday hearing on technology reform before the House Veterans Affairs Committee. Subcommittee. .

Incorrect medication records are the latest problem facing Cerner's Millennium Oracle system, which has been so damaged that the VA has stopped adapting it to other sites while it works to restore the network.

This is how the Oracle system feeds data into a medical records database known as a health information warehouse, which stores information about a patient's medications and allergies. When patients are prescribed a new medication, the provider checks the information in the database to make sure there are no allergies or drug interactions.

But because of a bug in the way Oracle's system encodes information sent to the database, when the database is compared to an older, popular electronic medical records system called Vista, the incorrect information is displayed.

This means that if a veteran visits one of the five medical centers that use the Oracle system, his or her medication history may be incorrect if he or she then seeks treatment at a facility that still uses the Vista system. As of September, the crisis had affected about 250,000 veterans, Case said, citing data from the Veterans Administration.

In one case, a patient suffering from post-traumatic stress disorder and traumatic brain injury was not taking the necessary medications to treat adrenal insufficiency because the inpatient rehabilitation program he was attending did not have a prescription, according to the release. . The rehab center used the Vista system, but the veteran received his medal at the center using the Oracle system.

Five days after his symptoms worsened, the patient found a prescription on his personal cell phone and had to be taken to a local emergency room for treatment, according to testimony.

The inspector general's office "saw no evidence that the VA adequately communicated this issue to previous EHR (electronic health records) vendors and the mitigation measures necessary to safely care for these new patients in the EHR," Case said. .

"Although traditional site managers require providers to perform manual medication safety checks to replace automated EHR checks for new patients, these manual safety checks are complex and rely on active pharmacists and front-line staff," he said. .

Executive Vice President, Oracle Corp. Mike Sicilia told lawmakers that his company made 10 separate corrections to data submitted to the healthcare database between May and November. However, the most recent software update, released a few days ago, revealed the same data issue during the last test and was quickly removed, Cicely admitted.

"For patient safety, we have decided not to do anything that does not pass all final safety checks," he said.

Sicily noted that the problems were not entirely Oracle's fault.

"I'm not sure we broke anything here," he said. “This is a very complex process and is the result of multiple systems, multiple versions of Vista, multiple EHRs, and multiple interfaces between them. In fact, we are responsible and have taken responsibility for correcting all defects in the system. Designed, developed and contracted at our expense.”

Lawmakers from both parties are increasingly frustrated with Oracle's $10 billion program, which covers just five locations in the Pacific Northwest and Ohio, amid growing concerns about patient safety over system failures. .

Under pressure from lawmakers to update electronic health records, the Veterans Administration announced in April that it was delaying implementation of the new system elsewhere while officials worked on repairs.

However, legislators' discontent with the new system is growing.

“The definition of insanity is doing the same thing over and over again and expecting different results,” subcommittee Chairman Matt Rosendale, R-Pa., said at the hearing.

VA electronic medical records are unlikely to be restored a year after they are deleted due to issues.

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