VA picks Cerner to replace legacy EHR system

Adopting the same Millennium platform as DoD will enable seamless care, says David Shulkin, MD.

In an effort to achieve interoperability with the Department of Defense, the Department of Veterans Affairs has decided to replace its decades-old electronic health record system with a commercial off-the-shelf EHR from Cerner.

While the VA will not be adopting the identical EHR that DoD uses, it will be on a similar Cerner platform. The U.S. military has started to deploy Cerner’s Millennium system, the same platform that has now been named as the replacement for the VA’s legacy Veterans Health Information Systems and Technology Architecture (VistA).

VA Secretary David Shulkin, MD, made the announcement on Monday at a news briefing at the department’s headquarters in Washington.

“At VA, we know where almost all of our veteran patients are going to come from—from the DoD, and for this reason, Congress has been urging the VA and DoD for at least 17 years, from all the way back in 2000—to work more closely on EHR issues,” said Shulkin.

“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,” he added. “For these reasons, I have decided that VA will adopt the same EHR system as DoD, now known as MHS GENESIS, which at its core consists of Cerner Millennium.”

As part of an initial operating capability, MHS GENESIS completed installation on February 7 at Fairchild Air Force Base, near Spokane, Wash. Fairchild AFB is one of four sites in the Pacific Northwest that will deploy the Cerner Millennium system in 2017, with full deployment of the EHR to be completed in 2022 and serving more than 9 million DoD beneficiaries globally.

Also See: DoD rolls out deployment of Cerner EHR system to Fairchild AFB

According to Shulkin, the VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the departments without the manual exchange and reconciliation of data. In addition, he made the case that modernizing VistA is long overdue.

“Having a veteran’s complete and accurate health record in a single common EHR system is critical” to care and improving patient safety, said Shulkin. “Our current VistA system is in need of major modernization to keep pace with the improvements in health information technology and cybersecurity, and software development is not a core competency of VA.”

In addition, Shulkin said that in the area of cybersecurity the VA intends to “leverage the architecture, tools and processes that have already been put in place to protect DoD data, to include both physical and virtual separation from commercial clients.”

At the same time, he noted that “courageous VA clinicians” began the “groundbreaking work in the basements of VAs in the 1970s” that led to the development of VistA. While Shulkin said he did not take his decision to replace the legacy EHR lightly, the situation has become urgent.

“Because of the urgency and the critical nature of this decision, I have decided that there is a public interest exception to the requirement for full and open competition in this technology acquisition,” according to Shulkin. “Accordingly, under my authority as Secretary of Veterans Affairs, I have signed what is known as a ‘Determination and Findings’ or D&F, that is a special form of written approval by an authorized official that is required by statute or regulation as a prerequisite to taking certain contract actions.”

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Using the D&F, he said the VA “may issue a solicitation directly to Cerner Corporation for the acquisition of the EHR system currently being deployed by DoD, for deployment and transition across the VA enterprise in a manner that meets VA needs, and which will enable seamless healthcare to veterans and qualified beneficiaries.”

In a written statement, Cerner said it was “honored and humbled” to be selected to replace the VA’s VistA system.

“We believe this project, in concert with ongoing progress towards implementing the Department of Defense’s MHS Genesis system, will lead to ongoing innovation, improved interoperability and the creation of a single longitudinal health record that can facilitate the efficient exchange of data among military care facilities and the thousands of civilian healthcare providers where current and former service members receive healthcare,” said the Cerner statement.

In 2015, the Pentagon awarded the Leidos-Cerner vendor team a 10-year, $4.3 billion contract award to modernize DoD’s EHR worldwide.

“We can’t wait years, as DoD did in its EHR acquisition process, to get our next generation EHR in place,” concluded Shulkin. “This is an exciting new phase for VA, DoD and for the country. Our mission is too important not to get this right, and we will.”

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