House appropriators have provided $65 million in Fiscal Year 2018 funding for the Department of Veterans Affairs’ recently announced plans to switch its legacy electronic health record system to a commercial product from Cerner. However, the funds come with strings attached.

VA announced June 5 that it plans to replace its decades-old legacy Veterans Health Information Systems and Technology Architecture (VistA) records system with Cerner’s Millennium EHR, the same platform that the Department of Defense is currently implementing as part of Military Health System (MHS) Genesis.

Also See: VA picks Cerner to replace legacy EHR system

The FY 2018 Military Construction, Veterans Affairs and Related Agencies Appropriations Bill states that no more than 25 percent of the funds can be obligated or spent until VA Secretary David Shulkin, MD, provides the following information to both House and Senate appropriators:

  • A detailed explanation of the solicitation submitted to Cerner for development of an EHR for VA.
  • An explanation of how the EHR would replicate the MHS Genesis system developed by Cerner for DoD, as well as the enhanced capabilities the VA requires to achieve complete interoperability with the military’s system and the VA’s commercial providers.
  • A strategic plan for development of the EHR, an associated implementation plan that includes timelines and performance milestones, a master schedule and annual and lifecycle cost estimates.
  • Information on plans to maintain current functionality and integration with DoD records during the transition to MHS Genesis.
  • VA plans to manage the transition process to MHS Genesis, including possible pilot programs, training for users and use of change management tools.

“The Secretary just made his announcement about the future of the electronic health record last Monday,” said Rep. Charlie Dent (R-Penn.), chairman of the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies, during a June 12 markup of the bill. “VA does not yet have an implementation plan nor an estimate of the cost of the commercial contract. While we support the decision to have a single health record and provide funding as requested, we fence 75 percent of the EHR funds in all relevant accounts until VA gets implementation plans in order.”

Shulkin told House appropriators last month that if the VA ultimately made the decision to go with a commercial EHR, then the agency would need additional funds from Congress to support the acquisition. However, Shulkin has yet to announce a price tag for replacing VistA with a Cerner system.

In 2015, the Pentagon awarded a $4.3 billion contract to a Leidos-Cerner team to modernize DoD’s EHR. However, the VA’s system has the potential to cost significantly more because the VA’s health system is larger and involves more facilities and veterans receiving care.

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