Black Book: Cerner is best EHR to replace VA's VistA
VA Secretary David Shulkin, MD, announced last month it would make a final decision in July on whether it will keep VistA or replace it with a commercial EHR. However, Shulkin is a vocal proponent for moving to a commercial EHR.
The VA sent two RFIs on April 12, seeking information from vendors about commercial off-the-shelf options and cloud-based options, as well as how to modernize VistA by stitching together multiple platforms.
To determine the best replacement, Black Book surveyed 30,000 EHR users and analyzed 24 key performance indicators (KPIS) for the five leading EHR vendors: Epic, Cerner, Allscripts, Meditech and athenahealth. It ranked vendors on which best helped combat the opioid crisis, improve care access, satisfaction, engagement and delivery, innovation of government agencies and government performance and fiscal improvement.
Cerner topped the list with an average score of 9.14 of a possible 10 across all categories and 24 KPIs. It also topped all categories.
Cerner outperformed in technology function to support providers attempting to combat the opioid crisis and scored highest in drug surveillance tools and prescription record tracking, behavioral health and addiction EHR capabilities. It also scored highest in IT outsourcing and privatization capabilities, tech support, hosting, interoperability and cybersecurity.
Allscripts came in second with a score of 8.91, finishing behind Cerner in all categories. Epic had a mean score of 8.17, athenahealth scored 7.89 and Meditech scored 7.66.
Black Book said that cost control, go-lives and improving client’s fiscal performance are Epic’s weakest areas.
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All of the ranked vendors scored about 7 in all KPIs and the first three categories except Meditech, which scored a mere 5.79 in patient portal and experience.
For some vendors, meeting the demands of improving government performance and fiscal improvement was the weakest area. Meditech scored 6.85 and Epic scored 6.75 here. However, Epic’s greatest weakness was improving the client’s fiscal performance (5.77).
athenahealth struggled with ERP and supply chain support (6.68) and vendor reputation, trust and viability (6.25).
VistA is over 30 years old and serves more than 1,200 Veterans Health Administration healthcare sites. It’s long been criticized by Congress for its failure to modernize and become interoperable with the Department of Defense’s EHR. DoD uses Cerner for its EHR.
Black Book managing partner Doug Brown, however, noted that VistA was a pioneer and the basis of many of today's commerical EHR architectures.
“Three of the companies represented in our Black Book report are taking inspiration from the spirit of VistA, even as they vie to replace it,” Brown added. “Cerner, Allscripts and Epic recently indicated they intend to make EHRs more open, utilizing application programming interfaces to enable third-parties to write apps for their platforms.”