VA Inks Contract for Massive New Health Record System

by Sandra Basu

June 10, 2018
Military Health Services, Genesis Patient Portal

WASHINGTON — Calling it one of the largest IT contracts in the federal government, with a ceiling of $10 billion over a decade, then-VA Acting Secretary Robert Wilkie announced that the agency signed a contract with Cerner for its new electronic health record (EHR).

“When fully deployed, the new system will represent a monumental advance in veterans’ health care—bigger than VA’s initial deployment of electronic health records 40 years ago.” Wilkie said in a statement last month.

The announcement comes after former VA Secretary David Shulkin, MD, earlier described a “pause” in moving forward with Cerner after some interoperability concerns were raised.

Pointing to the size of the contract, Wilkie said “you can understand why former Secretary Shulkin and I took some extra time to do our due diligence and make sure the contract does what the president wanted.

The signed contract comes after Shulkin announced last summer that the agency intended to adopt the same EHR platform as DoD. That shift in direction came after DoD and VA announced in 2013 it was embarking on separate paths for individual EHR solutions, a move that did not satisfy lawmakers.

With the new contract that would put both EHRs on the same platform, VA said it expects patient data “will be seamlessly shared between VA, DoD and community providers through a secure system” and that “care by all providers will be transparent to the entire system.”

Still, VA officials told lawmakers last summer that implementation would be a multiyear project. At that time, former VHA Acting Undersecretary of Health Poonam Alaigh, MD explained that, because VA has unique needs that are different from DoD’s, the veterans’ healthcare system would not simply be adopting the identical EHR that DoD uses. She explained the complexity of the implementation.

“This is one of the largest implementations ever for any healthcare system. You want to do it right. It’s patient safety. You don’t want to lose data. You want to make sure that all the users know exactly what to do. … This is not something you do with just the turn of the switch,” Alaigh said.

Capitol Hill

Lawmakers have complained for years about the lack of interoperability and that no EHR existed to meet the needs of both healthcare providers and veterans.

In response to the contract-signing announcement, House Committee on Veterans’ Affairs Chairman Rep. Phil Roe (R-TN) said the “transition should be done right, not fast.”

“I’m pleased the department took extra time to review the contract before moving forward. Oversight of implementation and spending will be critical as this process continues,” he said.

He also said that he and his staff have taken oversight trips to where MHS GENESIS had been implemented, both to check on DoD’s progress and to ensure “VA will learn from the problems that have arisen during DoD’s transition.”

“We will continue this rigorous oversight as site assessments and in-depth planning begin,” Roe said.

Rep. Tim Walz (D-MN), House Committee on Veterans Affairs ranking member, said that, while he is glad “this important process is finally underway,” he still has “many concerns with regard to how the Trump administration will implement” the EHR. He also pointed to challenges in the implementation of DoD’s Cerner system that has hampered that effort.

“The root cause of these issues must be identified and remedied before VA implementation can move forward,” Walz said.

At the same time, Walz’s bill, The Veterans’ Electronic Health Record Modernization Oversight Act of 2017, was making its way through Congress last month. The bill ensures Congress has oversight of the transition process and would direct VA to provide legislators with the project’s “key planning and implementation documents, in addition to copies of the contracts, to indicate the effort’s progress and how the money is being spent.” The bill also requires VA to notify Congress in the event of any significant cost increase, schedule delay, loss of veteran health data or breach of privacy.

“Whether it is preventing disruptions in patient care, protecting the privacy of veterans or ensuring American taxpayer dollars are invested responsibly and in a way that will improve healthcare delivery for veterans, my bill … will ensure Congress has the authority it needs to hold VA accountable every step of the way,” Walz pointed out.

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