- VA Secretary David Shulkin recently requested that Congress redirect $728 million from its current budget to fund the VA Cerner EHR implementation. Shulkin made the request at a House Appropriations Military Construction and Veterans Affairs Subcommittee hearing on Wednesday.
Shulkin stated the agency is eager to sign the contract with Cerner and complete negotiations to start the process of replacing the homegrown VistA system with a new commercial EHR. However, VA needs to reprogram some funds to sign the deal.
In total, VA hopes to redirect $782 million of fiscal year 2018 funding to start the project. Due to restrictions on transfers of funds into the VA Office of Information and Technology account, VA can only immediately reprogram $374 million in funds to kick off the deal. The Department requested to reprogram $324 million from its medical services fund and $50 million from a staff hiring budget.
The sooner VA signs the contract with Cerner, the sooner the agency can commence work on the initial rollout of the system, Shulkin said. The EHR system is slated to go live at the first VA site 18 months after the contract is signed.
“This has taken way too long and there have been many false starts along the way,” stated Shulkin.
Augmenting this sense of urgency is the potential for significant cost savings. Shulkin said the department stands to save money by implementing its system in tandem with the deployment of the Department of Defense (DoD) EHR system, MHS Genesis.
“We prefer to fund the plan as part of the enacted 2018 appropriations bill,” Shulkin said. “However, we have to do this quickly. We have achieved substantial discounts by aligning our EHR deployment and implementation with the Department of Defenses.”
VA intends to begin work implementing the Cerner system in regions where DoD is already deploying its own system, which would share resources between departments and increase efficiency.
“By us deploying into the same geographical area, we’ll be able to leverage the resources that are already in that area,” said VA EHR Modernization Executive Director John H. Windom.
Windom stated the overall cost of the 10-year implementation project could increase by up to 5 percent if VA fails to align its Cerner rollout with DoD’s own implementation timeline.
On top of generating cost savings, alignment between the Departments will also guarantee interoperability with DoD, Shulkin maintained.
He also requested Congress establish a new separate appropriation account for EHR modernization costs to get the implementation off the ground.
“That way we can capture everything in one place for the sake of full transparency and accountability,” Shulkin said.
Enabling full transparency and accountability throughout the Cerner implementation falls in line with other recently introduced legislation. In November 2017, four representatives asked VA provide Congress with its key planning and implementation documents throughout the EHR replacement project.
The Veteran’s Electronic Health Record Modernization Oversight Act of 2017 seeks to ensure VA provides Congress with information including the likely cost of the implementation.
In a press conference call, DoD Defense Healthcare Management Systems Program Executive Officer Stacy Cummings stated VA would be able to leverage the solid groundwork already set by the initial Cerner deployment at DoD sites in the Pacific Northwest.
"They are going to match their deployment schedule to ours," Cummings told reporters from FCW. "The great thing about that is the opportunity to partner up in the deployment of training as well as follow up training, and to make sure the infrastructure is optimized for the region as we bring on new users.”
VA is aiming to award Cerner the EHR contract by the end of November.