VA Requests $782M to Begin Cerner EHR Transfer

When Cerner won a contract to become the electronic health records (EHR) provider for the Department of Veterans Affairs (VA), Secretary David Shulkin, MD, indicated that IT upgrades would be the agency’s largest expense in coming years.

The extent of those costs became a bit clearer in a House Appropriations Military Construction and Veterans Affairs Subcommittee meeting today, as Shulkin requested $782 million to begin the changeover from its legacy VistA system to the Cerner platform.

Cerner was chosen in part because the Department of Defense (DoD) had already contracted the EHR provider. DoD has begun to implement Cerner systems in the Pacific Northwest, and the VA wants the funds so it can also begin to transition facilities in the region.

“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.

John H. Windom, executive director of the VA’s EHR Modernization program, also stressed urgency before the subcommittee.

“That critical alignment early in the process allows us to move out more aggressively and to be more efficient in our approach,” he testified, asserting that it would be easier to achieve DoD and VA interoperability if the Cerner rollout was done in tandem.

The expense would require hundreds of millions of dollars to be repurposed from the VA medical care budget allotted for fiscal year 2018. Shulkin said that funding would have been used to purchase medical equipment that could be procured later.

Some members of the subcommittee expressed skepticism and frustration at the request. Rep. Charlie Dent (R-PA) pointed out that the VA’s 2018 budget already included a $245 million cut in medical equipment spending even before this move. He called those additional cuts "a hard sell.”

“While I'm pleased that the VA is moving in the direction of creating an integrated health record system finally with DoD,” Rep. Debbie Wasserman Schultz (D-FL) added, “I was not thrilled about getting a $782 million programming at the end of October that needed to be acted on by November, with no real details.”

Shulkin admitted that the VA “does not have a great history” of delivering IT projects on time and within budget, but said that was why getting the Department out of the software development business was so necessary. Although a large expense up front, he argued, spending the money now would ensure interoperability and reduce the project’s costs in the long term.

“We will achieve DoD interoperability, that’s one piece of it,” Shulkin declared to the subcommittee.