The Department of Veterans Affairs has issued a request for information seeking industry feedback on how the VA might transition from its legacy electronic health record system to a commercial EHR.

While it continues to modernize the decades-old Veterans Health Information Systems and Technology Architecture (VistA) system, the VA is having second thoughts about whether the legacy EHR is able to meet its needs going forward.

“Over the years and due to local customization, there are few standard data elements, a variety of complex algorithms and heterogeneous mix of legacy hardware and software supporting 130 unique VistA instances across the VA enterprise, making modernization and standardization efforts extremely complicated, expensive and time consuming,” states the VA’s request for information.

“In order to deliver the vision of health care quality, access, choice and Veteran well-being, the Veteran Health Administration (VHA) requires effective, robust, and modern information technology systems,” it adds.

In a written statement, the VHA said it is “still gathering information to help form future decisions” and that “there is much work to do to make this strategy an actionable plan, and requests for information (RFI) are part of the process as we work through the project planning.”

According to the VA, the purpose of the RFI is to request industry feedback, guidance and recommendations on all aspects of the change management associated with a commercial-off-the-shelf EHR acquisition and transition.

However, the agency emphasized that it is an “RFI only” for planning purposes and “shall not be considered an Invitation for Bid, Request for Task Execution Plan, Request for Quotation or a Request for Proposal.”

What the department envisions is a solution offering that:

  • Provides a robust EHR system that would enable veterans and clinical providers to send, receive, locate and use electronic health information in a manner that is appropriate, secure, timely and reliable.
  • A system that is seamlessly interoperable with other systems, including those of the Department of Defense, private-sector providers and with other VA enterprise systems, such as those in the Veteran Benefits Administration.
  • Supports clinical workflow, evidence-based practice and patient safety.
  • Provides clinicians, patients and administrators with the data, analytic power and user interfaces required to monitor the effectiveness of care and improve veteran care over time.
  • Serves as a modernized VHA “system of systems of the future” that will include more than just a commercial EHR in order to facilitate and automate business processes that support access and veteran care.

LaVerne Council, CIO and assistant secretary for information technology at the VA, told a Senate appropriations subcommittee last month that it will continue to “deliver value for veterans and VA providers regardless of whether our path forward is to continue with VistA, a shift to a commercial EHR platform as DoD is doing, or some combination of both.”

Among its options, the VA is considering following the lead of the Department of Defense, which went with a commercially available EHR system last year, awarding a $4.3 billion contract to a Leidos-Cerner team.

“We’re committed to providing a modern health information system to our nation’s service members through our work with the Leidos partnership and the Department of Defense, and we’re happy with our progress to date,” said Cerner in a written statement. “We’re supportive of all efforts that improve the health of our veterans and will do anything we can to advance that initiative.”

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