VA CIO nominee says Cerner EHR could be rolled out sooner than 10 years

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While the Department of Veterans Affairs plans to implement a $10 billion Cerner electronic health record system over 10 years, the VA’s nominee to serve as CIO says he believes the timeline could be sped up.

“In my early discussions with the Electronic Health Record Modernization Office, there were some expressions of options to pull milestones forward,” testified CIO nominee James Gfrerer on Wednesday before the Senate Committee on Veterans’ Affairs, which held a hearing to consider his nomination. “There is every sense of urgency to make that timeline under 10 years.”

Gfrerer said that according to John Windom, acting chief health information officer of the VA’s Office of EHR Modernization, one of the risks to the project is “that in a 10-year program, it’s very easy to not be serious and urgent about those early milestones.

“If you don’t put some rigor and accountability on early in the process, it sends a message very early on that it’s just a matter of we can slip it until the next option year—and that’s going to have deleterious effect,” he added.

“When I hear 10-year schedule on the implementation of Cerner, that kind of makes me quite nervous,” Sen. Dan Sullivan (R-Alaska) told Gfrerer during the hearing. “I can’t believe that that is what the plan is.”

Also See: Congressman voices concerns about VA Office of EHR Modernization

If confirmed, Gfrerer would oversee the implementation of the agency’s IT systems including the enterprise-wide rollout of the Cerner Millennium platform, which is slated to replace the decades-old Veterans Health Information Systems and Technology Architecture.

“It’s going to take a concerted effort to maintain VistA—for example—for nine to 10 years,” noted Gfrerer, referencing the fact that the maintenance of the VA legacy EHR will continue until the new commercial-off-the-shelf Cerner system is fully deployed.

Gfrerer also made the case that “anytime you implement a commercial-off-the-shelf” system like Cerner, “there’s a huge change management component … clinicians are going to have to go through a very rigorous and substantial training, education and implementation process to kind of conform their workflows to the IT system.” Inherently, he said “it is about business transformation.”

Sen. Jon Tester (D-Montana), ranking member of the Senate Committee on Veterans’ Affairs, pointed out to the CIO nominee that the VA’s EHR modernization is “the largest healthcare IT transformation in American history” and that if he is confirmed and the project “goes south,” he will be held accountable.

Tester argued that more important than speeding up the timeline is ensuring that the Cerner system is implemented correctly because the EHR modernization is “really going to make or break the VA moving forward.”

According to Gfrerer, based on his military experience, he believes he has an understanding of the “intricacies of IT legacy systems and large-scale IT projects.” In addition, in his testimony, Gfrerer said he has “worked as an executive in the private sector doing IT and cybersecurity transformation for large commercial clients, further providing me with the experience and perspective to serve in the VA.”

The VA intends to create a single common EHR system with Department of Defense by leveraging a shared Cerner Millennium platform and the agency’s planned acquisition calls for aligning the deployment and implementation of the system with DoD’s ongoing rollout of its own system—called MHS GENESIS—to achieve efficiencies.

“That’s quite a bit of commonality to achieve across two different medical domains,” acknowledged Gfrerer.

The Senate Committee on Veterans’ Affairs will vote on Gfrerer’s nomination soon, according to Sen. Johnny Isakson (R-Ga.), chairman of the panel.

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