- The Department of Veterans Affairs (VA) will fully complete the Cerner EHR implementation and transition all VA patient health records to the new system in seven to eight years, according to testimony from VA Secretary David A. Shulkin, MD at a House Committee hearing on October 24.
However, Shulkin maintained the first Cerner implementation will likely go live within less than two years as planned.
“Once we negotiate the contract, it will be 18 months from the time that the contract is complete to the first site in VA going up,” stated Shulkin.
Representative Beta O’Rourke raised the question about when VA will have a usable EHR system capable of sharing patient health data that can also achieve “true interoperability with the Department of Defense (DoD.)”
VA chose Cerner to provide the platform for its commercial EHR in part because the DoD EHR system – MHS Genesis – also operates on a Cerner platform.
Shulkin revealed it will take significantly longer for VA to fully implement the Cerner system so that it contains comprehensive patient EHRs for all veterans and their families.
“We are thinking seven to eight years,” responded Shulkin.
O’Rourke expressed skepticism VA would implement the EHR system in a timely, cost-effective manner.
“It’s good for us to know and to be aware of as we think about implementing this that we’re looking at seven or eight years,” said O’Rourke. “This is not a scientific analysis but I have yet to see a VA budget for time or cost [that hadn’t been] exceeded. It usually goes beyond the budgeted time, beyond the budgeted cost, so that’s important for us.”
“This is a new VA, congressman,” responded Shulkin.
“I want to make sure we’re going into this eyes wide open,” said O’Rourke.
Earlier this month, VA issued a 30-day notification to Congress detailing its plans to negotiate a contract with Cerner that will allow for interoperability with DoD. The announcement came during the Senate Veterans Affairs Committee hearing.
“We released to Congress — to you — 30-day notice of award of a contract,” said Shulkin during the VA hearing. “We are keeping on the timeline that we talked about. We’re marching forward. We have the principles. I have some updates to share with you on the strategic IT plan, because I think we are making a lot of progress with that.”
Shulkin has not specified the cost of implementing the Cerner platform. However, the VA IT office must deal with a $215 million budget cut in the president’s fiscal year 2018 proposal. Additionally, an appropriations bill for 2018 designated about $78.6 billion in discretionary funding for VA healthcare modernization and improvements.
“We haven’t gotten to defining which specific tools they are yet, and how we’re going to meet those needs,” Shulkin said. “We’ve talked about the days of VA being a software developer are over, and we’re going to be looking at off the shelf, current technologies. There’s going to be a lot more definition on that.”
In June, three senators submitted a letter to Shulkin and DoD Secretary James Mattis requesting further information about the VA Cerner EHR replacement — including a projected timeline.
Senators John McCain, Johnny Isakson, and Jerry Moran emphasized the importance of an efficient integrated EHR system and acknowledged the efforts by both departments to coordinate their technology to enable seamless health data exchange.
“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.