VA preps for its sprint to acquire a commercial health record

After 17 years of mulling an integrated electronic health record, the Department of Veterans Affairs announced plans to sync up with Department of Defense's commercial health record system, VA Secretary David Shulkin announced June 5.

In a White House briefing, Shulkin said he hoped to have a contract with Cerner in three to six months. In that time, Shulkin said, VA will be "developing both the implementation plans and the cost of this system so that we can go out and make sure that we're doing this right and that we have the resources available to do it."

Shulkin added that "working with the Department of Defense and … using their planning materials and their change management tools, we will be able to do this much faster than if we had done it alone."

FCW has learned that Christopher Miller, who led the Pentagon's efforts to procure a commercial system over more than two years, has joined the VA as a special adviser to the CIO, effective June 5. The VA Office of Information and Technology is also in the midst of standing up a program executive office to coordinate the move to a commercial system.

Under a determination and finding document signed by Shulkin, VA is able to negotiate with Cerner on a sole-source basis. A VA source said that plans are to proceed directly with Cerner, separate from the integration team that is responsible for the DOD health record and that includes contractors Leidos and Accenture.

There's no word on the cost, but as Shulkin pointed out, VA is a larger organization than the Military Health System. DOD brought in its contract with the Leidos-Cerner team at $4.3 billion. VA will likely have to pay a lot more.

"I absolutely believe -- and I've spent a lot of time reviewing the materials -- it is in the public interest to move quickly.  And I also believe we can do this cheaper for the taxpayers by essentially moving forward quickly without a lengthy process," Shulkin said.

Former VA CIO Roger Baker said that the final tally could reach as high as $16 billion. "VA is bigger than DOD, and VA is going to want a whole bunch of changes," Baker said. "VA doesn't like that estimate," he added.

The move to negotiate a multi-billion contract on a sole-source basis is finding a lot of support in the federal IT community.

"It was a huge massive competition to arrive at MHS Genesis," said Dave Wennergren, a former DOD CIO.  And the systems, he points out, are designed to serve "the same human beings."

Rich Beutel, an attorney specializing in procurement law and a former legislative staffer who helped draft the Federal Information Technology Acquisition Reform Act legislation, welcomed the news.

"This has dragged on for years, and hundreds of millions of dollars have been wasted trying to find a solution," Beutel said. "It's a poster child for government dysfunction, siloing and insular thinking."

He takes Shulkin's point that the need for a new system is too urgent to spend 26 months on procurement, as was the case with the DOD system, particularly since that work has already been done. "Time is critical, and the amount of time spent on a procurement has to be acknowledged and factored into the acquisition plan," Beutel said.

It's not clear yet how the commercial electronic health record systems vendors that lost out on the DOD acquisition will respond to the news of Cerner's pending win.

"You have got to believe those companies are looking hard at their options," said a former VA tech staffer who spoke with FCW. That staffer also cautioned about looking at the move as a done deal. "Just because the VA secretary says it's going to happen, doesn't make it happen," he said, noting that former VA chief Eric Shinseki made a similar promise and didn't deliver.

"The DOD and VA have two completely different paradigms, one about readiness and the other about care. It will be interesting to see how those two cultures come together," the former staffer said.

Wennergren agreed that it made sense to adopt a wait and see attitude about success of DOD and VA moving to the same health record. "It's not the first time they’ve started to walk down the aisle together," he said.