Electronic Health Records Come Under Fire in Ventura County, Calif.

In a report issued this month, the county's civil grand jury said there was a lack of preparation and independent review in the 2013 transition by two hospitals and 40 clinics run by the Ventura County Health Care Agency.

by Tom Kisken, Ventura County Star / June 26, 2015

(TNS) -- A $50 million-plus transition to electronic health records at Ventura County-run hospitals and clinics has drawn criticism from the county grand jury for the third time in 13 months.

In a report issued this month, the Ventura County civil grand jury said there was a lack of preparation and independent review in the 2013 transition by two hospitals and 40 clinics run by the Ventura County Health Care Agency.

The project has cost about $50 million, much of it paid to Cerner Corp in Kansas City, Missouri. The county is paying $19 million more over 10 years to Cerner for monitoring and operating the system from Kansas City.

A separate grand jury report earlier this month on the county’s project management practices criticized the implementation of medical records. The grand jury in May 2014 issued a report saying the transition caused inefficient and delayed care.

County officials defend their handling of electronic records, pushed by federal mandates, and say the new grand jury report contains many of the same claims as last year’s document.

“The fact is we have a brand-new system we put into place that streamlined our patient care. It has streamlined our billing processes,” said Barry Fisher, director of the Health Care Agency. “It’s working.”

Grand jury Foreman Robert Stewart said last year’s report focused on the implementation. He said the new report looks at problems that lingered after the system went live.

“The primary reason,” he said of the new report, “is because we had complaints from the public concerning what happened after the system was live. There were still an awful lot of complaints.”

The new report concluded the Health Care Agency didn’t arrange for enough independent review of the project. It said the county didn’t come up with an effective plan to reduce risks.

“We’re not throwing the blame on the VCHCA,” said Stewart, adding that federal deadlines put the project on a fast track. “We’re just trying to point out ways the system could have been improved.”

Health Care Agency officials started planning for the transition in 2007, said Terrence Theobald, agency director of information technology. They spent almost four years looking for the best system.

They addressed risk management through a contract with Cerner that put most of the risk on the company.

“We didn’t cut any corners,” Theobald said.

The grand jury said system instability after implementation, including frequent crashes, meant health care staff temporarily administered care without access to recent records or relied on paper documents.

The report stated it took nine months to solve prescription-label issues that meant some staff members didn’t have needed information.

Many of the problems created the potential to affect actual care, although there were no reports of harm to patients, the grand jury said.

“It delayed things a little bit,” Stewart said. “It may also have put stress on the health care workers. ... I wouldn’t go as far as to say there are risks to the patients.”

Agency officials said medical records were always available when the system was not working — in paper form or through a backup electronic system that began operating after about a month.

They said pharmacy issues were caused by a late request and did not affect patient care. They said electronic records have improved billing.

Officials said there have been issues with the system, but they were expected and addressed.

The grand jury recommended adding policies to bring more review and risk management to future projects.

It suggested the county hire more information technology employees trained to focus on health care issues. Theobald said the agency is recruiting five new staff members.

©2015 Ventura County Star (Camarillo, Calif.) Distributed by Tribune Content Agency, LLC.

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