House Committee Apportions $65M for VA-Cerner EHR Modernization

The House Appropriations Committee has cleared the fiscal year 2018 Military Construction and Veterans Affairs Appropriations bill, which includes $65 million for the modernization of the VA electronic health record (EHR) system.

The $65 million allocation for the IT modernization project is the same as what President Trump requested in his 2018 budget request a few weeks ago. It was announced last week by VA Secretary David J. Shulkin, M.D., that the department will replace its aging EHR system, VistA, by adopting the same platform as the U.S. Department of Defense (DoD), a Cerner EHR system. “However, the agency also said that while it would be a similar Cerner platform as DoD, it would not be identical, citing the need to create an ‘integrated’ product in order to achieve interoperability with other healthcare provider organizations,” Healthcare Informatics’ Heather Landi reported on June 5.

However, according to a draft of the legislation released June 11 by the House Appropriations Committee, the two systems will be identical. The draft said that the funding “will ensure the swift implementation of the plan for the VA to use an identical electronic record system as the DOD. This will also ensure our veterans get proper care, with timely and accurate medical data transferred between the VA, DOD, and the private sector.”

The DoD awarded a multi-billion dollar EHR contract in 2015 to Leidos and Cerner. Although initial deployment was set to begin in December 2016, the contract was delayed and the deployment began this past February. The cost of that project has been reported to be more than $4 billion. As reported by Politico Morning eHealth this week, “It’ll cost a great deal more than [$65 million], of course, to implement a new EHR at the VA. Shulkin plans to go back to Congress with a much bigger proposal once he figures out the details of the switch to Cerner.”

The VA Appropriations bill, as it relates to the EHR upgrade, has restrictions attached to it, noting that “not more than 25 percent [of the funding] may be obligated or expended until the Secretary of Veterans Affairs submits to the Committees on Appropriations of both Houses of Congress.” The specific conditions include:

• A detailed  explanation  of  the  solicitation  submitted  to  Cerner  Corporation  for  development  of  an  electronic  health  record  for  the VA.
• An explanation  of  how  the  electronic  health  record  would  replicate  the  Military  Health  System  (MHS)  Genesis  record  developed  by  Cerner  for  the  Department  of  Defense,  as  well  as  the  enhanced  capabilities  the  Department  of  Veterans  Affairs  requires  to  achieve  complete  interoperability  with  the  Department  of  Defense  system  and  non-Department of  Veterans  Affairs  providers  who  participate  in  the  Department of Veterans Affairs healthcare system.
• A strategic  plan  for  development  of  the  electronic  health  record  system,  an  associated  implementation   plan   including   timelines   and   performance   milestones,  a  master  schedule  and  annual  and  lifecycle cost estimates.
• Information on  plans  to  maintain  current  functionality   and   integration   with   Department   of   Defense records  during  the  transition  to  MHS  Genesis.
• VA plans to manage the transition process to MHS Genesis, including possible pilot programs, training for users and use of change management tools.