A county-run hospital and clinic system mishandled the implementation of a massive electronic health record system, causing inefficient and delayed patient care, the Ventura County grand jury said in a report released Tuesday.
Grand jury members criticized the Ventura County Health Care Agency for not doing enough training, planning or hiring in preparation for a record system that went live on July 1 at the agency’s two hospitals and about 40 clinics and centers across the county.
“This was a reasonably large capital program and from the time you start your requests for proposals, you need to have something in place that lays out the whole program,” said Steven Weiss, foreman pro tem of the 19-member grand jury. “They did not have that, we concluded.”
The grand jury noted the problems delayed patient care and billing but did not allege people were endangered, Weiss said. A year earlier, county nurses complained the implementation created a series of problems, including patients waiting eight hours in emergency rooms.
Barry Fisher, director of the health care agency, said the grand jury report contained inaccuracies and was outdated because it didn’t credit the improvements made since July 1.
“Yes, we had some issues early on,” he said. “Where we are at today is night and day from where we started.”
Fisher said the county agency scheduled less patients for clinic appointments initially to deal with anticipated problems from the transition to electronic records. He said triage was used in emergency rooms to make sure patients received the care they needed.
The grand jury report criticized the health care agency in several areas related to the implementation including:
- Underestimating needs for training.
- Not authorizing a person to serve as project manager early in the preparation process.
- Not hiring enough staff.
- Ordering system hardware too late.
Weiss said the grand jury conducted interviews and studied documents, partly in search of evidence for project leadership and a plan where all tasks are identified and linked.
“We concluded they did not do that,” he said.
Fisher refuted criticisms regarding the project manager. He said the agency’s information technology leader was appointed project lead a full year before implementation. Later, an information technology specialist with extensive project management experience was hired and authorized to lead the project, he said.
“We always had a project manager,” he said.
Fisher said the county followed the recommendations of Cerner Corp., the Kansas City technology company contracted to help with the transition. The grand jury report said the county health care agency sent 40 staff members to training at the Cerner campus, contending Cerner recommended the training for 120 people.
“I don’t know where the 120 came from,” said Dr. Bryan Wong, medical director for the county’s two hospitals, expressing surprise at the allegation and asserting the county followed Cerner’s protocols.
The grand jury expressed concern about coming stages in the federal government’s push for increasing use of electronic records and made specific suggestions for use of a project management plan loaded with all needed resources and recognized by the Project Management Institute.
©2014 Ventura County Star (Camarillo, Calif.)