VA closes Web portal to eHealth records, cites data errors

One female patient had a prescription for erectile dysfunction in her record

The electronic health record (EHR) network portal for the U.S. Department of Defense (DoD) and Department of Veterans Affairs (VA) was shut down this week after the VA found errors in some patients' medical data that clinicians downloaded from the defense network, according to a patient safety alert.

Among the errors the VA detected through the Computerized Patient Record System's (CPRS) Remote Data View (RDV) -- its graphical user interface for clinicians -- was a prescription for vardenafil for a female patient. Vardenafil is used for treating male erectile dysfunction.

"The DoD pharmacy staff checked the prescription number and determined the vardenafil prescription was for another patient and verified the vardenafil prescription had not been ordered for or dispensed to the female VA patient," the alert stated.

The decision to shut down the portal was first reported by Nextgov.com.

As of Monday, all access to electronic Defense Department records through the computerized record system and VistAWeb was disabled, the VA said. The agency was not sure when the system would be restored.

VistAWeb is the VA's intranet portal to eHealth records through CPRS, and it allows remote medical facilities access to the VA's VistA EHR system. VistA stands for Veterans Health Information Systems and Technology Architecture.

Jean Scott, director of the Veterans Health Administration's Information Technology Patient Safety Office, said in the alert that the VA pulled the plug on the system because "the potential exists for decisions regarding patient care to be made using incorrect or incomplete data."

The VistAWeb is operated by the VA and is the largest and most comprehensive EHR system in existence, serving more than four million service members. Many medical IT experts consider it to be the archetype for EHR systems in the private sector, and vendors have copied its architecture in their own products.

As of March 13, all medical records for the DoD will be accessed by phone, fax, paper or other alternative methodologies, the VA said.

Other errors with VistAWeb and CPRS system include displaying some patient data incorrectly, incompletely or not displaying queried data at all.

"The VA clinician may see the patient's data during one session, but another session may not display the data previously seen," the VA said in its alert. "This problem occurs intermittently and has been reported when querying DoD Laboratory, Pharmacy, and Radiology reports."

The government has uncovered other prescription errors related to EHR systems that have been rolled out in private-sector hospitals as well. Sen. Charles E. Grassley (R-Iowa), sent a letter in January to some of the nation's largest health care facilities asking for any information on "issues or concerns that have been raised by your health care providers" over the past two years.

Grassley said the letter was prompted by concerns brought to his attention in recent months about EHR systems that included "administrative complications, formatting and usability issues, errors and interoperability."

In some of the most serious cases, incorrect medication dosages are being miscalculated by software that is interchanging patient body weights with kilograms and pounds.

IT managers also have voiced concerns that new regulatory deadlines from the government aimed a spurring EHR adoption in the private sector could wind up causing problems as people rush to deploy systems so they can claim a portion of billions of dollars in federal incentive monies.

According to the VA, no patients were harmed as a result of the errors in the EHR system.

Although the agency moved to shut down down the eHealth records exchange this week, it said it first discovered the problem in February with the Defense Department's EHR system, known as the Armed Forces Health Longitudinal Technology Application. That's when the erectile dysfunction prescription error occurred.

Officials at the VA could not be reached for comment.

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian or subscribe to Lucas's RSS feed . His e-mail address is lmearian@computerworld.com.

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