Unsealed VA EHR plans show designs for unified DoD/VA system, price info redacted

VA Secretary Shulkin said the agency plans to replicate the DoD EHR to create a single common system that will be implemented in 48 phases over the next 10 years.
By Jessica Davis
02:28 PM
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VA EHR plans

After months of waiting to hear details on the U.S. Department of Veterans Affairs’ plans to replace its EHR with Cerner, recently unsealed documents reveal the agency is hoping to create a single, common system between the VA and the Department of Defense.

To accomplish this, VA Secretary David Shulkin, MD, plans to replicate DoD’s Cerner EHR, which has successfully rolled out at four DoD sites.

The unsealed documents were written by U.S. Court of Federal Claims Judge Lydia Kay Griggsby, who just last month ruled to dismiss a lawsuit filed by CliniComp against the government for the VA’s no-bid contract with Cerner.

[Also: Cerner EHR project for VA will take 7 to 8 years, Shulkin says]

Her opinion shed light on Shulkin’s plans for the massive project. In fact, it’s the most detail shared with the public on how the VA intends to build its EHR.

According to the Determinations and Findings filed with the court by Shulkin, Cerner will install its EHR at 1,600 VA healthcare sites in the U.S. The contract will be implemented in 48 phases, including site visits, user training and onsite support, over the next 10 years.

But the cost of the EHR was redacted.

“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,” Shulkin wrote.

[Also: DoD rolls out Cerner EHR at second military site]

To Shulkin, a “single common system” would be implemented in a way that would allow the VA to adopt the same workflows, cybersecurity architecture, order sets and terminology as the DoD. In doing so, the VA’s EHR would work seamlessly with the DoD’s regardless of the agency where the patient receives care.

“Veteran’s complete and accurate health record in a single common system is critical to providing seamless, high-quality, [and] integrated care and benefits,” Shulkin wrote. “Records residing in a single common system will eliminate the reliance on complex clinical interfaces or manual data entry between DoD and VA.”

Further, by using a common system, the VA hopes to avoid repeating mistakes and capitalize on DoD’s lessons learned, while ensuring the VA won’t need to develop or maintain an increasingly complex EHR.

[Also: DoD says Cerner EHR deployment to reach next milestone in July]

Shulkin is also hoping the platform will make it easier to analyze the agency’s unique data sets to determine trends among service members and veterans. The system will also make it possible for the VA to make faster disability determinations -- an issue that has long plagued the agency.

Also noted was Cerner’s reputation for working closely with its clients to ensure the platform’s success.

“As the prime contractor and EHR software developer, Cerner is best positioned to not only lead software implementation but also to conduct a robust review of VA clinical processes for quality improvement and business transformation,” Shulkin wrote.

[Also: How the Coast Guard’s ugly, Epic EHR break-up played out]

The VA made the decision to replace its legacy VistA EHR in June, after two RFIs and a private audit. Shulkin said the VA went with Cerner to match the EHR already in place at the DoD.

Cerner will be in charge of the EHR and supporting functions like revenue cycle, inpatient and home care -- among others. The contract will also address non-clinical core functional requirements, which may include inventory management/supply chain capabilities.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com