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Conversion to Electronic Health Records Flawed, Says VC Grand Jury

In 2009 new federal laws mandated all public healthcare agencies to convert to electronic health recordkeeping—promising millions of dollars in incentive payments to those that fulfill certain conditions and phase in specific changes by set dates over the next few years.

The 2013-2014 Ventura County Grand Jury recently finished an investigation into how the Ventura County Health Care Agency (VCHCA) carried out the crucial first stage of this conversion.

The grand jury ultimately concluded that the agency’s handling of its transition to the new system had serious flaws, leading to a period of inefficient and delayed patient care after the “go-live” date of July 1, 2013. Billing processes were significantly impacted, requiring manual intervention and additional time.

The grand jury points to the following key causes of the less-than-smooth change:

  • VCHCA underestimated its technology needs and therefore time, training, staffing, and other resources were insufficient;
  • The implementation lacked a detailed, recognized-standard project plan, as well as an experienced project manager to oversee, track, and report on progress;
  • VCHCA did not hire enough qualified “contract staff” to support the project; and
  • System hardware was ordered too late to allow enough time for configuring of computers, onsite testing of all components, and fully familiarizing users with the new equipment and procedures.

According to the grand jury, the VCHCA can be better prepared for stages two and three of the electronic health records implementation by adopting the following recommendations:

  • Institute a standard for capital projects, using a PMI-recognized project-management plan, for example, a Gantt-chart-type software program;
  • Have an experienced, dedicated project manager in place throughout the life of capital projects;
  • Allocate the required time and resources to each project to ensure that all software and hardware is on site, tested, and installed to support proper implementation; and
  • Provide appropriate staff training for all projects that involve new systems and/or procedures.

The grand jury’s full report, titled “Healthcare Records Processes and Procedures,” has just been published on its website, It includes a step-by-step timeline of the system rollout process.

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