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the switch to a commer- cial system but urged Shulkin to get moving on appointments. “It’s very important that we get people in perma- nent positions on your team,” Tillis said, noting that there were as many as nine open political appointments, includ- ing VA’s CIO post. He warned that a plan for the commercial EHR procurement could “slide more to the six- month side if we don’t have permanent leaders in place.”
Tillis, who also serves on the Senate Armed Services Committee, raised the possibility of including a timeline for connecting the MHS Genesis system to DOD and VA in the Defense AppropriationsAct.
In the House, appropriators are bud- geting $65 million as a down payment on the new system and are eager for the project to go forward, but the funding comes with conditions.
The House Appropriations Com- mittee has said that the fiscal 2018 VA and military construction appropria- tions bill will include those funds to “ensure the swift implementation of the plan for the VA to use an identical electronic medical record system as the DOD.”
“The implementation of an effective electronic health record system that provides integrated service between the departments of Veterans Affairs and Defense has been a bipartisan priority and goal for a long time,” said Rep. Charlie Dent (R-Pa.), chairman of the appropriations subcommittee that funds VA.
In return for the funding, the commit- tee wants detailed explanations of the
solicitation to Cerner, information on how the company’s EHR system would replicate and interact with the MHS Genesis system fielded by DOD and details on how it will mesh with com- munity health care systems. Lawmakers also want to know how the transition from VistA to Cerner’s EHR system will work, including cost estimates, training and change management.
VA will have to meet those conditions in order to obligate or spend more than 25 percent of $418 million in planned IT modernization funding.
On the Senate side, Sen. Jon Tester (D-Mont.) cautioned Shulkin not to wait on his request for supplemental funding for the new EHR system.
“You need to be asking us to plus that money up,” said Tester, who is the ranking member of the Veterans’ Affairs Committee and also serves on the Appropriations Committee.
Yet Sen. Joe Manchin (D-W.Va.)
wanted assurances from Shulkin that VA would not get “taken for a ride” on the sole-source pro- curement with Cerner.
Shulkin responded to that concern by saying, “We certainly know the price that DOD paid, and we know the price we are currently paying to maintain our systems. We’re seeking the best way to do this for tax- payers.”
The end of VistA?
Although VA is plan- ning to phase out its EHR, Baker said VistA is not going away any- time soon. The MUMPS- based architecture also supports procurement, scheduling, inventory and other business sys- tems at VA.
“VistA is going to have to exist side by side with the new record in my estimation for 10 years,” he said. “That’s how long it’s going to take to roll the new record all the way through. And there are so many things that an electronic health record doesn’t do that VistA does that they’re going to have to keep those modules work- ing or replace them with commercial
software.”
Shulkin has not yet publicly
addressed the VistA timeline in detail, but he did acknowledge the challenge of ensuring interoperability with legacy data and applications.
“We...have a strong need to build back in ties to our current electronic medical records,” Shulkin said. “We have 30 years of really useful data but also innovations that have been devel- oped by our clinicians. I’m not willing to give up on that. DOD did not build back into their legacy systems the way that we’re going to need to.” n
“VA’s adoption of the same EHR system as DOD will ultimately result in all patient data residing in one common system.”
VA SECRETARY DAVID SHULKIN
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AP PHOTO/CAROLYN KASTER