Timeline, budget for VA health record switch in progress

Department of Veteran Affairs Secretary David Shulkin told a Senate panel it could take up to six months before a plan is in place to acquire services from commercial electronic health record provider Cerner.

Shulkin announced the move to replace VA's homegrown Vista EHR system with one from Cerner on June 5. The Department of Defense uses a system based on the Cerner Millennial EHR service, and by using the same vendor, Shulkin said the DOD and VA could achieve their long promised goal of true interoperability.

The VA has tapped the expertise of Christopher Miller, the DOD acquisition executive who led the procurement of the commercial health record system, to advise acting CIO Rob Thomas. The veterans' agency is planning to create a program executive office to plan a sole-source procurement with Cerner as authorized by Shulkin. The DOD's system cost $4.3 billion over nine years, and the VA system is likely to cost much more than that.

"We need approximately three to six months to come up with a plan," Shulkin told lawmakers at a June 7 hearing of the Senate Veterans Affairs Committee. "I'm feeling optimistic about the path forward, but I'm cautious enough to share some of your concerns," he said.

"Show me the money," said Sen. Richard Blumenthal (D-Conn.). "I feel we really need to be hardheaded and demanding here because changing the system and saying we're going to abandon the present system may have unintended consequences," he said.

Sen. Thom Tillis (R-N.C.) welcomed the move to switch to a commercial system but urged Shulkin to get moving on appointments. "It's very important that we get people in permanent positions on your team," he said, noting that there were as many as nine open political appointments. The VA's CIO is among these. Tillis warned that a plan for the commercial procurement could "slide more to the six-month side if we don't have permanent leaders in place."

Tillis, who also sits on the Senate Armed Services Committee, raised the possibility of including report language in the National Defense Appropriations Act with a timeline for connecting the MHS Genesis system at the Department of Defense and the VA's system.

Shulkin told lawmakers that the mood overall at VA is cautious, given the big changes planned not just for the health record but those related to pending VA workforce legislation and an expansion of the community care program that allows vets to receive VA-funded medical care from outside providers.

"I think there are a lot of people who are still watching. There may be some that are still hopeful and some people that are concerned about the changes," Shulkin said. "Whenever you're going through change and you're trying to make decisions quicker … you're going to have some people that are anxious," he said.