The House Appropriations Committee has released its Military Construction and Veterans Affairs bill for 2019, including $1.2 billion for the new VA electronic health record (EHR) system.
In total, the legislation provides $96.9 billion in discretionary funding – $4.2 billion above the fiscal year enacted 2018 level. As stated in a press release from the Appropriations Committee, “The bill contains $1.2 billion for the new VA electronic health record system. This will ensure the implementation of the contract creating an electronic record system for VA that is identical to one being developed for DoD [The Department of Defense]. These two identical systems will ensure our veterans get proper care, with timely and accurate medical data transferred between the VA, DoD, and the private sector.”
It should be noted that the legislation does not mention Cerner, the health IT vendor that VA awarded a contract to modernize its EHR system, by name, but the language does foreshadow that the VA-Cerner EHR contract will be signed eventually since it mentions that the IT system mirror the DoD’s, which was developed by Cerner. To this end, VA Press Secretary Curt Cashour recently wrote in a statement that one of VA’s specific near-term priorities is to “finalize a decision on the department’s electronic health record modernization.”
Reports have surfaced that the contract, which has not yet been signed, will be in the $10 billion range, making it one of the largest health IT implementations in history. The hefty cost has concerned Congressional members since that $10 billion figure doesn’t even include infrastructure improvements or implementation support.
As Healthcare Informatics reported last month when President Trump ousted VA Secretary David Shulkin, M.D., negotiations between VA and Cerner have been delayed. In December, Shulkin announced “a strategic pause” in the EHR acquisition process, with the purpose being to conduct an assessment of national interoperability language contained in the Request for Proposal that would ultimately support an EHR contract award. MITRE Corporation would be conducting the external assessment and Shulkin said earlier this month that MITRE provided the VA with 51 recommendations, and that the agency was building these into the contract with Cerner.
Reports at the time were that Shulkin was set to sign the Cerner contract soon, but nonetheless, other EHR vendors saw his dismissal as a potential signal that they could get back in the bidding process. One such company, CliniComp International, a San Diego-based EHR vendor, sued the government last summer, attesting that VA improperly awarded its EHR upgrade contract to Cerner without a competitive bidding process. Following Shulkin’s firing yesterday, Chris Haudenschild, the CEO of EHR firm CliniComp, said in a statement, per a recent Politico’s eHealth newsletter, that "Acting Secretary Wilkie should delay the award of any EHR modernization contract so that the next Secretary has an opportunity to fully review the facts."
As this all continues to play out, Robert Wilkie, DoD undersecretary, is serving as acting VA secretary in the interim. Rear Adm. Ronny Jackson just recently withdrew as President Donald Trump's nominee to lead the VA due to allegations around his professional conduct.