Three U.S. senators have written a letter to Veterans Affairs (VA) Secretary David Shulkin, M.D. and Defense Secretary James Mattis asking for a timeline for VA’s Cerner EHR project and for plans to ensure that the technology systems of the VA and DoD will be integrated.
The letter, from Sens. Jon McCain (R-Az.), Johnny Isakson (R-Ga.) and Jerry Moran (R-Ks.), noted that major federal IT infrastructure upgrades and overhauls have not been largely successful of late. They said that they remain optimistic about VA’s electronic health record (EHR) transition, however. It was announced earlier this month by Shulkin that VA would adopt a similar Cerner EHR system as the DoD.
The senators wrote, “We hold great concern that the scope of this project brings several risks related to excess costs and implementation delays. We implore the VA to work with DoD’s experts to adopt any lessons learned and best practices from DoD’s recent experience with Military Health System Genesis (MHS) implementation. We cannot afford any mistakes on this project, as it has immense implications for the future of VA and for the proper care of our millions of veterans.”
Recently, the House Appropriations Committee cleared the fiscal year 2018 Military Construction and Veterans Affairs Appropriations bill, which included $65 million for the modernization of the VA EHR system—for year one alone. At the time of the EHR upgrade announcement from Shulkin, he cited the need to “create an ‘integrated’ product in order to achieve interoperability with other healthcare provider organizations.”
Interoperability between the technology systems of VA and DoD has long been called into question after an effort to create a single EHR for both agencies fell apart in 2013 despite spending nearly $1 billion in its attempt.
Meanwhile, the DoD awarded a multi-billion dollar EHR contract in 2015 to Leidos and Cerner. Although initial deployment was set to begin in December 2016, the contract was delayed and the deployment began this past February. The cost of that project has been reported to be more than $4 billion with an estimated finish date of 2022.
The senators wrote that as the two federal departments work together to create an integrated EHR platform, they need to address several questions, including:
- What is the implementation and phasing plan? What is the projected timeline and what are the major completion milestones?
- What are DoD’s best practices that can be learned and adopted by VA?
- How can both departments ensure that that the solution deployed will transcend VA, DoD and community systems, following a veteran across the entirety of the provided care options, ensuring seamless, real-time access to medical records documentation?
- What legislative or policy barriers do you foresee?