The challenge faced by Synensys and its partners, JP Systems, Deloitte, and Massachusetts Institute of Technology (MIT) was to improve the data quality within the Veterans Health Administration’s (VHA) complex real-world data (RWD) system, which includes over 150 medical centers, thousands of outpatient clinics, and numerous community healthcare partners. Since 2019, the VA has been operating two different Electronic Health Record (EHR) systems creating numerous data quality challenges that negatively impacted the quality of Veteran healthcare.

Our system safety team implemented a series of comprehensive analyses and assessments to identify and manage previously unidentified system hazards that were leading to defects and errors. We conducted a CAST (Causal Analysis based on Systems Theory) and STPA (System Theoretic Process Analysis) to identify and mitigate risks within the VA RWD systems. Additionally, they performed Independent Verification and Validation (IV&V) to assess and enhance the quality of health data exchanges between the VA and Community Care partners. These efforts included technical changes, increased governance, improved system monitoring, and recommendations for implementing interoperability standards and structural changes.

By identifying and addressing data quality issues, Synensys and its partners have helped ensure that Veterans receive accurate, precise, and meaningful health data, ultimately improving clinical decision making and patient care. This work has led to safer integration of the EHR systems, reduced the risk of adverse events, and optimized the data exchange processes, thereby enhancing the overall quality and safety of healthcare services provided to U.S. Veterans.