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The U.S. Department of Veteran Affairs (VA) has selected Cerner Corp., to provide a replacement for the outdated self-developed VistA EHR system. Earlier this year, United States Secretary of Veterans Affairs David Shulkin said a decision needed to be made about the VA EHR system, suggesting an off-the-shelf EHR system was the best choice and that a final decision would be made by July 1.
Shulkin said, “Seamless care is fundamentally constrained by ever-changing information sharing standards, separate chains of command, complex governance, separate implementation schedules that must be coordinated to accommodate those changes from separate program offices that have separate funding appropriations, and a host of related complexities requiring constant lifecycle maintenance.”
The cost of continued development of VistA was considered to be too great, especially with the prospect of ongoing interoperability problems. The VA has already invested hundreds of millions of dollars into VistA, yet the EHR is still only semi-interoperable with the system used by the Department of Defense (DOD). Cerner was the natural choice since it is the system used by the DOD.
Shulkin said, “Without improved and consistently implemented national interoperability standards, VA and DoD will continue to face significant challenges if the departments remain on two different systems.”
The DOD EHR system took 26 months to implement; however, the VA urgently needed to change systems to improve interoperability and security and could not wait years. Shulkin therefore made the decision to move systems without market competition, signing a Determinations and Findings document which allowed the VA to approach Cerner and choose the MHS Genesis system on a sole-source basis.
Shulkin said the use of Cerner’s system “will ultimately result in all patient data residing in one common system and enable seamless care between the departments without the manual and electronic exchange and reconciliation of data between two separate systems.”
The VA also plans to use the same architecture, tools and processes used by the DOD to secure its system, which will see a significant cybersecurity enhancement over its existing system.
While the decision has been made to implement Cerner’s system, that does not spell the end of VistA just yet. Transitioning to the new system will take time. VistA will need to be run in tandem with the new EHR for some time to come as VistA has functions that Cerner’s system does not. It could therefore take a decade before VistA is fully retired.
Shulkin said, “We’re embarking on creating something that has not been done before: an integrated product that, while utilizing the DoD platform, will require a meaningful integration with other vendors to create a system that serves Veterans in the best possible way.”
President Donald Trump welcomed the move saying, “This is one of the biggest wins for our veterans in decades. And I congratulate Secretary Shulkin for making this very, very important decision.”