Page 42 - FCW, July 2017

IT Modernization
to a $73.7 million sole-source add-on for just a single year of data hosting by Cerner.
VA also must find a vendor or ven- dors to handle some of the tasks of inte- grating the new system, which Shulkin said will be the next order of business.
“Right now, my issue is getting there quickly,” he said at a June 20 breakfast with reporters hosted by the Christian Science Monitor. “I’ve determined the best way to do this is directly with Cern- er, and we will be looking for help from what I’d call an integrator through sepa- rate procurement.”
Leidos is the integrator working with Cerner at DOD but was not part of the June 5 announcement. A statement from Cerner after Shulkin announced his sole-source plan simply said the company will build a “team of innova- tive and experienced partners” to work on the VA project.
During an investor conference in June, Leidos CEO Roger Krone said VA was moving faster than expected, and it’s possible that Leidos could help VA with the integration.
Regardless of how the integration is handled, former VA CIO Roger Baker said the final tally for VA’s EHR sys- tem switch could reach as high as $16 billion.
“VA is bigger than DOD, and VA is going to want a whole bunch of chang- es,” he said, adding that “VA doesn’t like that estimate.”
Mainly positive reactions
The choice to negotiate a multibillion- dollar contract on a sole-source basis is finding support among members of the federal IT community.
“I think it’s the right decision,” Baker told FCW. “But the main thing they’ve got to do is implement exactly what DOD implemented. Otherwise, you don’t get the interoperability that’s the prime mover for the decision.”
Baker was VA’s CIO when the Obama administration floated a plan to have DOD and VA collaborate on acquiring a
commercial EHR. That effort was even- tually abandoned, leaving VA to contin- ue with VistA and DOD to go it alone.
David Norley, a spokesman for DOD’s Defense Healthcare Management Sys- tems, also welcomed VA’s decision. DHMS is overseeing the implementa- tion of MHS Genesis at DOD.
“MHS Genesis is a smart thing for VA, and also I think it is the best thing for the veteran,” Norley said. He added that he understood “there will be one configuration of instantiation of MHS Genesis,” which would include data from VA, DOD and Cerner’s client base.
He also said VA’s adoption of the sys- tem would not have an impact on DOD’s schedule to complete its initial operat- ing capability by fall 2018 and field the system throughout DOD by 2022.
“It was a huge, massive competition to arrive at MHS Genesis,” said Dave Wennergren, a former DOD official who was involved in that effort and is now a managing director at Deloitte. The sys- tems are designed to serve “the same human beings.”
Rich Beutel, an attorney specializing in procurement law and a former Capi- tol Hill staffer who helped draft the Fed- eral Information Technology Acquisition Reform Act, also welcomed the news.
“This has dragged on for years, and hundreds of millions of dollars have been wasted trying to find a solution,” he said. “It’s a poster child for govern- ment dysfunction, siloing and insular thinking.”
Beutel backed Shulkin’s argument that the need for a new system is too urgent to spend 26 months on a procure- ment, as was the case with the DOD system, particularly because 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,” he said.
There were words of caution, too. For example, if VA institutes a uniform clinical workflow similar to what the Military Health System did in prepara-
tion for moving to a commercial system, it will mean big changes for medical providers.
“For 40 years, doctors at VA have had the ability to customize the soft- ware to local needs. That’s why VistA is the way it is,” Baker said. “That is a massive culture change in the second largest organization in the federal gov- ernment. Nobody should minimize the impact of that.”
A former VA technology staffer who spoke with FCW on condition of ano- nymity seconded that concern and cau- tioned against viewing the move as inev- itable. “Just because the VA secretary says it’s going to happen doesn’t make it happen,” he said, adding that former VA Secretary Eric Shinseki made a similar promise and didn’t deliver.
“DOD and VA have two completely different paradigms, one about readi- ness and the other about care,” the for- mer staffer said. “It will be interesting to see how those two cultures come together.”
And although he was less pessimistic, Wennergren agreed that it made sense to wait and see whether DOD and VA can successfully move to the same EHR. “It’s not the first time they’ve started to walk down the aisle together,” he said.
Dollars and dates
Congress has long been after VA to reform or replace VistA, but it will have to wait a little longer. “We need approxi- mately three to six months to come up with a plan,” Shulkin told lawmakers at a June 7 hearing of the Senate Veterans’ Affairs Committee, adding that “I’m feel- ing optimistic about the path forward, but I’m cautious enough to share some of your concerns.”
“Show me the money,” Sen. Rich- ard Blumenthal (D-Conn.) said. “I feel we really need to be hardheaded and demanding here because changing the system and saying we’re going to aban- don the present system may have unin- tended consequences.”
Sen. Thom Tillis (R-N.C.) welcomed
24 July 2017 FCW.COM