VA Clarifies What It Wants from Cerner

(VA Medical Center in Manhattan. Image has been cropped. Courtesy of Beyond My Ken, Wikimedia Commons.)

The world has known for months that the Department of Veterans’ Affairs (VA) will be moving its electronic health records (EHR) operations to Cerner Corp.’s platform, but specifics of that arrangement have been hard to come by. Late last week, the federal government dumped a trove of documents that outline its requirements for the deal.

The award will be a Single Award Indefinite Delivery/Indefinite Quantity Task Order contract, which is standard for a long-term technology contract. It acts as an umbrella covering the scope of the large project, which will comprise several phases and tasks.

The VA expects several specific functionalities from Cerner’s EHR technology, ranging from workflow improvements to analytics tools for value-based care and suicide prevention efforts. Cerner will be expected to provide “program management, an enterprise-wide EHR system, change management, training, testing, deployment services, sustainment and other solutions encompassing the entire range of EHR requirements,” including hosting, software, and necessary hardware. It also demands providence and pedigree of information, allowing administrators to track how data in the EHR networks originates, moves, and is altered over time.

The documents say that, when implemented, the new system should become the VA’s “authoritative source of clinical data to support improved population health, patient safety, and quality of care.”

The agency also expects Cerner to “provide a solution to archive the complete medical record from VistA,” which is the legacy EHR system that it is replacing. “The archiving solution shall place the legacy data in a relational database,” the documents state. “The archiving solution shall be searchable by account IDs, name, social security number, or data source.”

Interoperability with the Department of Defense (DoD) is emphasized in the documents, and is seen as the primary reason why the VA selected Cerner for its services. The company won a $4.3 billion contract with the DoD in 2015. Last week, VA Secretary David Shulkin, MD, indicated that the final contract was being held up due to uncertainty over whether Cerner could provide that interoperability in full. The newly-released documents indicate a desire for information sharing capabilities that exceed industry standards.

The VA’s contract is expected to be more expensive than the DoD's. In a meeting of the Information Technology Subcommittee in the House of Representatives earlier this month, VA officials indicated that the 10-year deal would cost at least $1 billion per year. Members of Congress were skeptical of the ask, based on the Department’s previous software expenditures.

In November, Shulkin requested $782 million to begin the transition in its facilities in the Pacific Northwest. The DoD has started changing over its hospitals in that region to Cerner’s platforms, and the VA wants to follow suit to begin building interoperable communications early.

“We have to do this quickly. We have achieved substantial discounts by aligning our EHR deployment and implementation with the Department of Defense's,” Shulkin said at the time.