VA plans to create a single common EHR with DoD
The Department of Veterans Affairs intends to create a single common electronic health records system with the Department of Defense using a shared Cerner Millennium EHR platform, according to a recently released court document.
The revelation comes from the U.S. Court of Federal Claims which last month dismissed a legal complaint filed by CliniComp International, a San Diego-based EHR vendor, seeking to prevent the VA from making a sole-source award to Cerner in order to replace the agency’s legacy Veterans Health Information Systems and Technology Architecture (VistA).
Specifically, Judge Lydia Kay Griggsby’s opinion references a Determination and Findings document issued in June by VA Secretary David Shulkin in which he states that “it is in the public interest to directly solicit a sole source contract to Cerner to achieve a single common EHR system with the DoD.” Using the Determination and Findings document, Shulkin insisted that he had the legal right to issue a solicitation directly to Cerner for the acquisition, which Judge Griggsby supported in her decision.
VA officials were not immediately available for comment.
However, David Norley, communications director for the Defense Healthcare Management Systems, observes that DoD’s MHS Genesis contract with prime contractor Leidos to implement the military’s Cerner system is separate from VA’s impending contract with the EHR vendor. Nonetheless, he contends that the ultimate goal is to create a “one electronic health record and one experience” solution shared by the two agencies.
“There will be a lot of coordination between DoD and VA—and the coordination has already started. DoD has provided the VA with a lot of information that it can about its own contract,” says Norley. “We believe that it’s in the best interests of our service men and women, veterans, and American taxpayers that we are in as close alignment as we can—to the extent of making it one system.”
The VA is expected to close a deal with Cerner this month in the form of a no-bid contract. Although the court document redacted the cost estimate of the contract over a 10-year period, it indicated that Cerner would provide services to about 1,600 VA healthcare sites nationwide and that the implementation will take place in 48 phases, including site visits, user training and onsite support.
According to Judge Griggsby’s decision, Shulkin’s Determination and Findings document states that “veteran’s complete and accurate health record in a single common system is critical to providing seamless, high-quality, [and] integrated care and benefits,” adding that a single common system will “facilitate the transition of active duty military members to VA (because) records residing in a single common system will eliminate the reliance on complex clinical interfaces or manual data entry between DoD and VA.”
In addition, the document touts the benefits of “common workflows, common cybersecurity architecture and terminology based on national standards, along with a patient portal that transitions with the patient from active duty to veteran status.”
Shulkin’s document also states that “having the VA replicate the DoD’s existing EHR system will allow the VA to avoid repeating mistakes and capitalize on the DoD’s investments” and that a single common system between the agencies will avoid having the VA “develop [or] maintain an increasingly complex” EHR system.
Currently, DoD has deployed Cerner’s Millennium system—the same platform that will replace the VA’s VistA—to four military sites in the Pacific Northwest. In 2013, VA and DoD scrapped a joint effort to develop a single system called the integrated electronic health record system.