Running head: EHR IMPLEMENTATION BY VENTURA COUNTY HEALTH CARE 1

AGENCY

EHR Implementation by Ventura County Health Care Agency

Rebecca Suan

Gonzalo Fernandez

Ross Barrios-Medina

Luisedmundo Vicente

Kendra Tovar

November 3, 2019

California State University Channel Islands

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As technology keeps advancing, more industries are using technology in their systems.

This can include workfields like hospitals, which are using electronic health records instead of

having paper records in some cases. Electronic health records can be needed to improve many

factors in hospitals if it has the right training, goes through procedures, and can be financially

afforded. In the case of Ventura County Health Care Agency (VCHCA) applying electronic

health records the outcome was that they submitted a request for a proposal for health electronic

records in 2009. The next year, the agency submitted another request for a proposal that called

for the use of electronic prescribing and health information exchange. Ventura County made a

few mistakes when applying a new electronic health record system.

The implementation of a new program can only cause problems. According to VCHCA

Director Barry Fisher he stated that, "Yes we had some issues early on," but added, "Where we

are at today is night and day from where we started.” This only meant that they were not ready to

start the implementation of Cerner. According to Kisken (2015) with the implementation of this

new system there were expected issues and were addressed.

This new electronic health record that was implemented in Ventura County had a few

deficiencies. Inefficient ordering of hardware was a key component in it failing. The hardware

was ordered in May of 2013. That purchase consisted of the laptops and servers. According to

FA-09, the hardware did not arrive until late June of 2013. That set them back because then the

hardware was not configured until the weekend before the go-live date of July 1, 2013. The time

allowed to assemble was so insufficient that VCHCA mobilized all IT personnel to complete the

task. Once it was completed it was available to all staff for usage. Regarding the implementation

of a new Electronic Health Records system by the Ventura County Health Care Agency and why
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they wanted it up and running even after their hardware was delayed was because they needed to

meet the meaningful use standards. Those standards are set by HITECH and the final date for

new systems to be completed was the end of December 2014. VCHCA chose to go live July 1st

because they would qualify for full Meaningful Use funding and to avoid federal penalties. It

was determined that the hardware testing performed by VCHCA was inadequate. Time

constraints did not allow for site testing throughout all areas of the hospital which was part of the

implementation process. The Grand Jury found that VCHCA ordered the user hardware in May

and June 2013. They ruled that that was too late to allow proper time for configuring computers,

hardware testing, and user familiarization. It was also found that VCHCA had until the end of

December 2014 to implement the new EHR system to avoid federal penalties. Initially they

rushed the process for no reason.

When reviewing the Ventura County Grand Jury report of the investigation implementing

an EHR system in Ventura County, the investigation gathered many evidence to prove that that

system had flaws during its developing stages. The report under fact twelve (FA-12), states that,

“Cerner’s recommended minimum for training at its facility was 120 VCHCA staff;

approximately 40 VCHCA staff attended training at the Cerner campus”. When developing the

implementation of an EHR it is always recommended that all staff members participate in

training to meet the requirements of proper use of an EHR system. As Cerner recommended that

the minimum for training at their facility with 120 staff members, only 40 participated in training

while there was an absence of 80 members from the leftover amount to meet that minimum

requirement. If Cerner facility noticed that a few of its staff members participated in the training

of the EHR going below the minimum, should have taken measures into informing its staff on
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the importance of the training. In terms of proper training by Cerner's facility it was safe to say

that they went below their recommended minimum of training, therefore failing to meet proper

training when implementing their EHR system and more so of problems when dealing with

EHR.

On top of the improper training with the staff there was also a lack of a dedicated and

experienced project manager to oversee the implementation. Under the report of the Ventura

County Grand Jury, findings four (FI- 04), states that, “The absence of a dedicated and

experienced project manager to oversee, track, and report all tasks contributed to staff being

inadequately prepared for using the new system, as well as to a problematic EHR system

implementation”. This can drastically lead to many problems occurring with the implementation

of EHR use without a professional personal with a background of knowing EHR to assist in

overseeing the project. With the absence of a dedicated and experienced project manager, staff

that were put through the training course or not, had difficulties in moving forwards without

proper help and ensuring that each project goal was completed before moving onto the next step.

Additional evidence to support this claim was under the correlating finding of finding six (FI-06)

that states, “Staff training on the new equipment was insufficient, leading to a lack of experience

with and knowledge of components of the EHR system. There was a period of inefficient and

delayed patient care”. Without an overseer ensuring proper staff training, now lead many staff

members to continue the use of the new EHR system without checking if each staff member was

ready for the implementation of an EHR system, resulting in staff to have inefficiency and delay

in patient care.
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After researching and investigating the EHR implementation by the Ventura County

Health Care Agency (VCHCA), we have found that this implementation failed to accomplish its

goal of incorporating EHRs to their system. An investigation done by the Ventura County Grand

Jury found that there were numerous flaws in the implementation of EHRs. There was a lack of a

dedicated and experienced project manager to oversee the tasks of EHR implementation. There

was not a standard project plan which affected the preparedness of the staff. The staff were not

adequately trained in how to use the new system. The Grand Jury also found that user hardware

was ordered late and did not allow time for configuration of computers, testing, or

familiarization. After their investigation, the Ventura County Grand Jury concluded and

recommended that the VCHCA have an experienced project manager in place, allocate time and

resources to ensure software is properly implemented, institute a standard for capital projects,

and allocate time for staff to be appropriately trained. If these recommendations are followed,

then the VCHCA will be better prepared for the following stages of meaningful use.
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References

Grand Jury Finds Flaws in Ventura County's EHR Implementation. (2014, June 4). Retrieved

from

https://californiahealthline.org/morning-breakout/grand-jury-finds-flaws-in-ventura-countys-ehr-

implementation/.

How one county botched its EHR rollout. (2015, August 3). Retrieved from

https://www.healthcareitnews.com/news/how-one-county-botched-its-ehr-rollout.

Kisken, T. (2015, June 26). Electronic Health Records Come Under Fire in Ventura County,

Calif. Retrieved October 26, 2019, from

https://www.govtech.com/dc/articles/Electronic-Health-Records-Come-Under-Fire-in-Ventura-C

ounty-Calif.html.