House balks at $10 billion price tag for VA-Cerner EHR project | Healthcare IT News

VA Secretary David Shulkin, MD, testifies at the House VA Committee meeting on Thursday. Credit: YouTube

VA Committee Chair Phil Roe was also concerned that the amount doesn’t cover maintenance or the cost to update the infrastructure necessary to accommodate the new platform.

As the time draws near for the U.S. Department of Veterans Affairs to sign its EHR contract with Cerner, Congressional members are growing increasingly concerned over not only the $10 billion price tag, but that the agency will need to keep the legacy system in place, perhaps indefinitely.

“While the EHR modernization effort is necessary, it is very expensive,” House VA Committee Chairman Phil Roe, MD, R-Tennessee, said during the Thursday hearing on the VA’s 2019 budget requests.

“The contract with Cerner alone has a price tag of about $10 billion and that doesn’t even include the costs of updating infrastructure to accommodate the new EHR, implementation support or sustaining VistA up until the day it can be turned off,” he continued.

In fact, Roe is concerned that the VA’s legacy EHR may never be completely gone.

“After visiting Fairchild Air Force Base in Spokane, Washington, recently, I’m not even sure you can ever turn VistA off,” Roe said.

President Donald Trump released his proposed FY19 budget this week, which earmarked $1.2 billion to get the project with Cerner off the ground. VA Secretary David Shulkin, MD put the potential Cerner contract on hold in January, pending an independent review of Cerner’s interoperability capabilities.

While Roe applauded Shulkin’s move to ensure interoperability, he’s still not certain the project can be successful.

“It’s unthinkable that VA could potentially spend billions of dollars on a project that doesn’t substantially increase the department’s ability to share information with the Department of Defense or community providers,” Roe said. “But that’s exactly what could happen if VA fails to proceed in a careful deliberate manner.”

In response, Shulkin stressed that the agency is taking the modernization very seriously.

“We have to make sure that we can be interoperable with dozens of different health systems out there,” said Shulkin. “And that’s a challenge that frankly the American healthcare system hasn’t figured out yet… We think VA can help lead this for the whole country by making this interoperable.”

Shulkin recognized the agency’s track record of failed IT projects – the Government Accountability Office recently reported that the VA likely wasted at least $1.1 billion on multiple EHR modernization attempts – and understands that this EHR replacement must work.

Given the size and scope of the project – there are more than 130 versions of VistA operating right now – Shulkin said the legacy system will need to be maintained over a 10-year implementation period.

To account for that, Shulkin is requesting Congress provide the VA a separate account to fund the project. The account would provide the VA with the necessary funds for maintaining VistA and implementing the Cerner EHR, and would provide transparency to where those funds are going.

The VA is expected to sign the Cerner contract in the next few weeks, after the vendor reportedly passed its independent assessment.

Source: House balks at $10 billion price tag for VA-Cerner EHR project | Healthcare IT News


EHR interoperability: A global conundrum | For the latest in interoperability, health information exchange (HIE) and connected care.

Black Book Research survey reveals “an enduring confusion on the definition of a highly interoperable EHR system outside the United States.”

Maybe it’s no wonder that interoperability appears to be an elusive goal in healthcare, since the vast majority of healthcare professionals around the world struggle to even define interoperability.

A new global survey by Black Book Research shows that 90 percent of the nearly 12,000 responding healthcare professionals across 23 countries say they are unsure about what constitutes a highly interoperable electronic health record (EHR) system.

“There is an enduring confusion on the definition of a highly interoperable EHR system outside the United States,” Black Book said. “Seventy-two percent stated in 2017 that their regional preferable strategy for electronic health records is to link disparate systems through messaging, APIs, web services and clinical portals. Only seven percent of all international EHR survey respondents described their regional HIT system as having ‘meaningfully connectivity’ with other providers.”

The seven-month poll, which closed in January, surveyed 11,838 doctors, clinical leaders, healthcare administrators, and technology managers.

Fortunately, many of these non-U.S. provider organizations are moving toward interoperability. Poll results reflect a pending shift away from siloed EHR systems in Europe, the Middle East, and South Asia, where nearly 57 percent of respondents foresee a move to comprehensive healthcare IT systems with data exchange and care coordination capabilities.

Countries with the highest potential for progressing EHR interoperability and expanded health IT functionalities beyond their local regions are (in order) New Zealand, Denmark, Israel, Singapore, Netherlands, Germany, Hong Kong, Norway, Australia, Canada, Sweden, Finland, United Kingdom, Switzerland, and France.

“A number of countries have launched national initiatives to develop ICT-based health solutions including EHR systems and have progressed well, despite several hurdles,” Black Book managing partner Doug Brown said in a statement. “As the obstacles are clearing with technological and non-technological interventions, approved standards and regulatory frameworks, funding and health-tech guidelines, the growth opportunities for U.S.-based global EHR vendors magnify as well.”


Source: EHR interoperability: A global conundrum | For the latest in interoperability, health information exchange (HIE) and connected care.