- Earlier this week, three senators submitted a letter to Department of Veterans Affairs (VA) Secretary David Shulkin and Department of Defense (DoD) Secretary James Mattis requesting further information on the VA EHR replacement, including a projected timeline.
Senators John McCain (R-AZ), Johnny Isakson (R-GA), and Jerry Moran (R-KS) stressed the importance of an efficient integrated health system and applauded the efforts made by both departments to coordinate their technology. Isakson chairs the Senate Committee on Veterans’ Affairs of which Moran is a majority member.
“We remain optimistic about the VA’s EHR transition; however, we hold great concern that the scope of this project brings several risks related to excess costs and implementation delays,” the senators wrote.
The undersigned senators advised those involved in the VA Cerner EHR implementation to work with DoD experts and adopt their implementation strategies and best practices to ensure the process goes smoothly.
DoD gained experience with implementing Cerner technology during the recent development of its own EHR system, Military Health System (MHS) Genesis.
While both department’s EHR platforms use Cerner technology, the systems will not be identical. However, both systems using the same vendor’s technology should ease of the task of enabling interoperability between VA and DoD.
“We cannot afford any mistakes on this project, as it has immense implications for the future of the VA and the proper care of our millions of veterans,” stated the senators.
While DoD and VA collaborate to develop VA’s EHR platform, the senators requests the following information:
- Understanding the enormous scope of this project, what is the implementation and phasing plan? What is the projected timeline and what are major completion milestones?
- Given the Federal government’s history of IT upgrade challenges, what are DoD’s best practices and lessons learned that can be adopted by the VA? What specific plans, controls, or managerial tools are the VHA prepared to execute to ensure the aforementioned best practices are reviewed and adopted, when prudent?
- How can both Departments ensure the implemented solution will transcend DoD, VHA, and community systems, following a veteran across the entirety of the provided care options, ensuring seamless, real-time access to medical records documentation?
- What, if any, legislative hurdles or policy barriers do you foresee, and how can we work together to ensure the success of this joint initiative?
- What assessments of business process re-engineering will the VA undertake early in the acquisition lifecycle of your EHR initiative?
- What oversight mechanisms will you put in place to ensure that the VA has sufficient understanding of the existing business processes to be changed and that the VA will avoid excessive customization of the selected commercial off-the-shelf system?
- What efforts, if any, will be made to integrate Investment Review Boards (IBRs) at the beginning of the budget process to ensure sound budget decision-making in connection with this initiative?
- Do the DoD and VA intend to align the tenure of program executives responsible for the execution of this initiative with key decision points to improve their ability to hold responsible personnel accountable?
By encouraging both departments to work together during the Cerner EHR implementation process, the Senate intends to reduce redundancies and combine resources for solutions.
Last week, VA Secretary David Shulkin released a statement further explaining ways the VA budget request for fiscal year (FY) 2018 will assist in funding the department’s EHR modernization and other projects.
In his letter, Secretary Shulkin stated the newest iteration of VistA, called VistA 4, will be completed over the next year using the Cerner EHR platform.
Secretary Shulkin did not specify the cost of implementing the platform.