Interoperability shouldn't have fueled VA's Cerner decision, HL7 exec says
The U.S. Department of Veterans Affairs announcement in early June that the agency would move its outdated EHR system to Cerner has been received with mixed reviews.
While some wonder if Cerner is the best choice, Congress and the President hailed the decision as the best route to data sharing between VA and DoD.
However, HL7 Chief Technology Officer Wayne Kubick hopes the decision to move specifically to Cerner wasn’t based on interoperability alone. That’s because the VA should be able to capitalize on FHIR with whatever platform the agency chose, he said.
The HL7 standard for electronically exchanging health data is web-based and makes it easy for providers to receive targeted requested data.
“So doing it for the sake of interoperability doesn’t make sense,” Kubick said. “There are a lot of APIs that work for individual products.”
A lot of organizations have both: their own product and a move to FHIR APIs. Kubick said that HL7 has been encouraging its customers to do that. If the common interoperability mechanism is being used, the VA could go with any commercial product.
But the move will be good for interoperability, as both Cerner and Epic are some of the largest adopters of FHIR specifications. Both Cerner and Epic have attested to the intention to use FHIR-based APIs within the platforms to fuel interoperability.
Further, the move to Cerner should shift the VA from being a single player that everyone needs to plug into to become interoperable, to a platform more similar to what everyone else in the industry is using, said Kubick. The agency will also gain a lot of data and functions.
“Cerner is a good platform and its team is doing things in a similar environment [with the DoD],” said Kubick. “But to me, the important thing is moving from a very robust platform that needed support. With the technology getting older, it was a good idea to move away from it.”
Further, since “Cerner has adopted FHIR intrinsically within the platform, the interoperability function should be there,” he said.
Before the decision was made, industry experts pointed out that VistA could be fixed and that a commercial EHR wouldn’t be able to replace the broken system.
While that may be the case, custom products add risk and added costs, said Kubick.
“The VA should leverage what Cerner is offering and use what everyone else is using,” he said. “It brings more people into the same FHIR-based fold: people doing things the same way, using the same applications and the FHIR capabilities.”
“It’s a good choice for Cerner and for the VA, but I don’t think it makes a big impact on interoperability,” he added. “I don’t think the VA picker Cerner for just interoperability… The fact is there’s a major healthcare system adopting a commercial system that supports interoperability, which is positive trend.”