- A few years have passed since the Department of Veterans Affairs came to terms with the scheduling crisis in Phoenix that led to numerous leadership changes and a financial commitment of more than $600 million to implement an Epic scheduling system.
That contract is now canceled to pave the way for Cerner’s scheduling software, a component of the $10-billion EHR modernization project, to be put on an accelerated timeline and implemented at all VA medical facilities, including those yet to upgrade to the Cerner EHR.
“Given that Cerner was awarded a no-bid contract to replace VistA, we recognized VA would likely be required to use Cerner scheduling at some point in the future,” said Epic spokesperson Meghan Roh. “We thank VA, our partners, and the team at the Columbus VA Ambulatory Care Center for their work on a wonderfully successful scheduling pilot.”
In 2015, VA entered the five-year, $626-million contract with Epic and Leidos, its partner for the scheduling system. Abandoning the Medical Appointment Scheduling System (MASS) — dubbed Epic Cadence when launched live in 2018 — will mean the federal agency won't reap the $350 million in savings if the scheduling solution had rolled out ahead of schedule.*
Editor's note: The article originally misstated the number of dollars spent on the project.
Last June, Leidos Vice President for Veterans Health Will Johnson was brimming with confidence about the rollout.
“We communicated to the VA that we are able to do a national deployment in 24 months,” Johnson told the Wisconsin State Journal. “We can do that for less than $350 million.”
Epic and Leidos began developing software for the scheduling system in June 2017 to serve a Columbus VA outpatient clinic and four smaller clinics in surrounding communities. Johnson explained that an earlier plan to launch a test run for the scheduling system in Boise, Idaho, was delayed and ultimately scrapped for an unknown reason.
The pilot project team developed the Epic scheduling system solution in 10 months. The system first went live on April 9, 2018. Epic maintained the scheduling system contract win despite VA’s selection of Cerner to provide a $10- billion EHR replacement for the homegrown legacy VistA system.
According to Epic, MASS contributed to significant improvements at VA. Total completed appointments have increased by 10 percent; wait-time metrics have decreased by 7 percent. Behavioral health and primary care witnessed 18- and 30-percent improvements, respectively, for wait times.
VA revealed increases in productivity and reductions in the time spent on scheduling between 30 and 50 percent. What’s more, MASS conformed to provisions of the VA MISSION Act of 2018 tied to modernization efforts by the Veterans Health Administration.
But Epic and its partners recently received word from VA signaling the end of MASS.
“The VA intends to separate the scheduling component within the EHR Cerner contract and implement it on a faster track. VA believes that there is a return on investment in productivity and efficiency realized by accelerating the scheduling system. This will improve access for Veterans and streamline workflow for staff,” wrote Acting Associate Deputy Assistant Secretary Jerome Pannullo is an official report to Congress dated December 20.
“Infrastructure costs are not expected to change; however, resources will be required sooner than the 10-year deployment schedule currently planned,” Pannullo continued. “To mitigate the risks, VA will not begin these deployments until after the full Electronic Health Record implementation is achieved at the two sites in VISN 20 [VA Northwest Health Network].”
VA hinted at the possibility of swapping Epic for Cerner last month. In a letter to VA Acting Deputy Secretary James Byrne, House Subcommittee on Technology Modernization Chairman Jim Banks (R-IN) 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. The chairman also noted the preference among VA leaders to implement Cerner’s scheduling solution.