House balks at $10 billion price tag for VA-Cerner EHR project
As the time draws near for the U.S. Department of Veterans Affairs to sign its EHR contract with Cerner, Congressional members are growing increasingly concerned over not only the $10 billion price tag, but that the agency will need to keep the legacy system in place, perhaps indefinitely.
“While the EHR modernization effort is necessary, it is very expensive,” House VA Committee Chairman Phil Roe, MD, R-Tennessee, said during the Thursday hearing on the VA’s 2019 budget requests.
“The contract with Cerner alone has a price tag of about $10 billion and that doesn’t even include the costs of updating infrastructure to accommodate the new EHR, implementation support or sustaining VistA up until the day it can be turned off,” he continued.
In fact, Roe is concerned that the VA’s legacy EHR may never be completely gone.
“After visiting Fairchild Air Force Base in Spokane, Washington, recently, I’m not even sure you can ever turn VistA off,” Roe said.
President Donald Trump released his proposed FY19 budget this week, which earmarked $1.2 billion to get the project with Cerner off the ground. VA Secretary David Shulkin, MD put the potential Cerner contract on hold in January, pending an independent review of Cerner’s interoperability capabilities.
While Roe applauded Shulkin’s move to ensure interoperability, he’s still not certain the project can be successful.
“It’s unthinkable that VA could potentially spend billions of dollars on a project that doesn’t substantially increase the department’s ability to share information with the Department of Defense or community providers,” Roe said. “But that’s exactly what could happen if VA fails to proceed in a careful deliberate manner.”
In response, Shulkin stressed that the agency is taking the modernization very seriously.
“We have to make sure that we can be interoperable with dozens of different health systems out there,” said Shulkin. “And that’s a challenge that frankly the American healthcare system hasn’t figured out yet... We think VA can help lead this for the whole country by making this interoperable.”
Shulkin recognized the agency’s track record of failed IT projects – the Government Accountability Office recently reported that the VA likely wasted at least $1.1 billion on multiple EHR modernization attempts – and understands that this EHR replacement must work.
Given the size and scope of the project – there are more than 130 versions of VistA operating right now – Shulkin said the legacy system will need to be maintained over a 10-year implementation period.
To account for that, Shulkin is requesting Congress provide the VA a separate account to fund the project. The account would provide the VA with the necessary funds for maintaining VistA and implementing the Cerner EHR, and would provide transparency to where those funds are going.
The VA is expected to sign the Cerner contract in the next few weeks, after the vendor reportedly passed its independent assessment.