- VA is leaning toward scrapping its 2015 scheduling system contract with Epic in favor of Cerner’s scheduling software, according to Subcommittee on Technology Modernization chairman Jim Banks (R-IN.)
In a letter to VA Acting Deputy Secretary James Byrne, Banks urged the federal agency to make a decision about which appointment scheduling software it plans to implement as part of VA’s $10 billion EHR modernization project.
“In the coming days, my understanding is that VA will be complying with the requirement of H.Rpt. 115-929 and announcing a decision as to how the nationwide implementation of a modernized medical scheduling system will be accelerated,” wrote Banks.
“I share the Appropriations Committee’s interest that such a scheduling system, meaning one that is resource-based, permits comprehensive veteran self-scheduling, and is accessible on multiple platforms, reaches all Veterans Health Administration facilities as quickly as possible,” he added.
The scheduling module part of VA’s homegrown VistA system is riddled with inefficiencies and lacks internal controls, leading to long wait lists for veterans.
A pilot of Epic’s Cadence scheduling system at VA’s care sites in Columbus, Ohio was successful in improving appointment scheduling. The system launched on time and came under budget, according to reports.
“While all available information indicates VA’s pilot of the Epic Cadence scheduling system in Columbus, Ohio has been successful, my understanding based on testimony from and conversations with Department leaders is that VA’s preference is to implement the Cerner Millennium scheduling package, because it has either already been purchased or a commitment has been made to purchase it,” said Banks.
“If that is the case, accelerating the nationwide implementation would entail decoupling scheduling from the rest of the Electronic Health Record Modernization (EHRM) program’s timetable,” he added.
Banks expressed frustration with the stunted implementation of VA’s Medical Appointment Scheduling System (MASS), which has “stopped and started repeatedly,” he wrote.
“It seems if Epic Cadence’s implementation had been unimpeded it could have been nearly complete by now,” stated Banks.
Given VA is now considering terminating its contract with Epic and instead implementing a Cerner scheduling system, Banks requested answers to six questions pertaining to the scheduling system installation process within the next 90 or 150 days.
First, Banks requested information about how the scheduling system’s resource-based capabilities will be used to increase efficiency, reduce wait times, and make better use of healthcare resources.
“What metrics will be put in place, and how will results be measured?” asked Banks.
The Congressman also asked about how much the Cerner Millenium scheduling package will cost.
“If it is not severable from a larger software package, how was that determined, and how much does that software package cost?” inquired Banks.
Banks also seeks information about how the EHR modernization implementation cost will be affected by the decision to separate the cost of the scheduling software from the rest of the project.
Additionally, the Congressman asked about the cost of deploying Epic Cadence according to the accelerated timeline being considered for the Cerner Millenium scheduling package as opposed to the original timeline established for the MASS contract.
“Would there be meaningful schedule differences in an accelerated Cerner scheduling implementation compared to an accelerated Epic scheduling implementation?” he wrote.
Finally, Banks asked whether VA has considered publishing scheduling resources along with its recently-launched Fast Healthcare Interoperability Resources (FHIR) server.
Overall, Banks urged VA to continue operating its Epic scheduling system at care sites in Columbus, Ohio regardless of the scheduling system it ultimately chooses to implement.
“Time and money have already been invested to implement it, and by all accounts it is functioning well,” wrote Banks. “Perhaps more significantly, the MyChart patient portal which was implemented along with Cadence could serve as a valuable interoperability test bed at little or no additional cost.”