So, Who's Left at the VA, and What Does that Mean for the Cerner Deal?

The Department of Veterans’ Affairs (VA) Acting Chief Information Officer Scott Blackburn resigned this week. He is the 4^th high-ranking VA official to leave the agency in the last 6 months.

In a Tuesday morning tweet, he posted a note thanking his former employer for the chance to work in the agency. “My effort has always been about better caring for Veterans regardless of Presidential administration, Republican or Democrat—and I have been honored to serve alongside both in a bipartisan way,” he wrote, adding that he would remain “both VA’s biggest cheerleader and critic from afar.”

The move adds more mystery to the fate of the agency’s long-planned electronic health records (EHR) transformation project. On June 5, 2017, former VA Secretary David Shulkin, MD, announced that the deal would go to Cerner. This was the VA’s executive leadership page the day after:

And this is what it looks like today:

The top 4 officials are no longer there, those who would have played important roles in helping the agency procure and implement a multibillion dollar deal with vital healthcare implications.

In the time between, numerous milestones have come and gone without an actual contract materializing. It was speculated that the announcement would come during Shulkin’s keynote at HIMSS last month in Las Vegas, but it did not, and the Secretary was fired via Presidential tweet just weeks later. His Chief of Staff, Vivieca Wright Simpson, resigned amidst the ethics scandal that may have contributed to his downfall. And Poonam Alaigh, MD, tasked with running the VA’s health system, stepped down in September.

As Chief Information Officer (and onetime Acting Deputy Secretary), Blackburn would have been a vital voice in the EHR Modernization program’s implementation. Appearing before Congress in December, he acknowledged that the conversion would be a tall task. The VA’s health system is the largest integrated health system in the country, but Blackburn said that the new Cerner platform would help it “keep pace with the improvements in health IT and cybersecurity that the current system, Vista, is unable to do.”

Now, the agency will have to face the same challenges without its top IT boss. Rollouts have been rocky in the Department of Defense (DoD), according to many reports. The VA chose Cerner to fall in line with DoD, but that agency halted their transition briefly earlier this year to shore up the process. In the meantime, the project’s future is uncertain: Vista remains in place, and Cerner did not immediately return calls for comment on the situation.

Confirmation hearings for Shulkin’s nominated replacement, White House physician Ronny Jackson, MD, will begin on April 25^th. They’re expected to be contentious—widely respected as a doctor, Jackson’s resume has been scrutinized for a lack of management experience, which could be essential for overseeing a massive health system currently undergoing (or, trying to undergo) major IT changes.

Related Coverage:

Coast Guard Hops on Defense Department's Cerner Pact

Shulkin Fears Polarization, Privatization of VA Following Dismissal

VA Secretary Says Agency Must Replace "130" Different EHR Systems