- The U.S. Department of Veterans Affairs' embattled EHR modernization project with Cerner took a step forward this week with the launch of a new scheduling system in Ohio, part of a $16 billion contract that's been dogged by delays, infrastructure problems and leadership turnover since 2018.
- The new system at VA Central Ohio Healthcare System in Columbus, Ohio, went live Friday, in an update a Cerner spokesperson called a "critical milestone in the project."
- Following the go-live, VA plans to begin implementing the full EHR at the Mann-Grandstaff VA Medical Center in Spokane, Washington, this fall. Prior to multiple delays, that facility was scheduled to go live in March.
In May 2018, the VA, the nation's largest healthcare provider, began a decade-long project to migrate its health data from its customized VistA platform to a unified Cerner EHR. It's hit a series of notable snags due to a lack of coordination with the Department of Defense, which is co-developing the system with the VA, along with the departure of top health IT officials.
The contract has been the subject of controversy from the start, with some lawmakers and others questioning why it was awarded with no bidding process. Meanwhile, spending has snowballed from the initial $10 billion price tag to $16 billion to cover rising program management and infrastructure costs, sparking concerns from government watchdogs and Congress.
An April report from the VA Office of the Inspector General concluded the VA hadn't prepared properly for the project, and its medical facilities required significant upgrades to physical and information technology infrastructure before they're ready for a new EHR. The lack of readiness jeopardized the new system and contributed to delays, OIG said.
The pandemic upended the project's planned implementation schedule in the second major delay this year, with VA Secretary Robert Wilkie in early April directing his office to reallocate resources to managing the coronavirus pandemic. The first delay this year, in February, stemmed from user concerns during testing of Cerner's new system at the Mann-Grandstaff VA Medical Center.
However, Cerner said in its second quarter earnings late July it had continued background work and planned to be onsite in the near future. VA plans to deploy the full EHR beginning in October this year, at select facilities in the Pacific Northwest, and scaling nationwide over the next several years.
After full EHR implementation across all VA sites, the department's facilities will be interoperable with the Department of Defense, linking the records of current service members and veterans. Previously, the VA and DOD had limited capability to share medical records, complicating efforts to track longitudinal care as service members transferred from active duty to post-military life.
The new scheduling system at VA Central Ohio Healthcare System aggregates clinician availability and other resources in one central location, with the goal of helping VA schedulers make appointments. Patients will also be able to schedule and cancel their appointments online. Previously, VA staff had to log into multiple applications to coordinate calendars, doctors, rooms and equipment, a process that included time-intensive manual data entry.
In preparation, Cerner migrated the information of some 60,000 veterans receiving care at the Ohio facility over to the new platform.
Despite the pandemic, software companies are continuing hospital system go-lives. In April, Cerner rolled out its cloud-based CommunityWorks EHR platform at Macon Community Hospital in Lafayette, Tennessee., in the EHR giant's first all-virtual deployment. And in July, Lake Health District in Lakeview, Oregon, went live with its Cerner platform after delaying the original launch by three months.