VA locks in $10 billion EHR deal with Cerner

After a sudden announcement of a $10 billion, sole-source contract with Cerner last year for a new Electronic Health Record (EHR) system, then-Secretary of the VA Shulkin faced questions from other industry members and Congress over the decision. After the dismissal of Secretary Shulkin in March and reports of shortcomings with the new Cerner-led EHR system at DOD this month, acting-Secretary of the VA Robert Wilkie announced that the department had finally signed the Cerner contract on May 17th, 2018.

In a May 17th statement, acting-Secretary Wilkie described the contract as “one of the largest IT contracts in the federal government.” The VA received $782 million in FY18 funding for the project, which will partly contribute to the contract’s $10 billion ceiling over 10 years. Acting-Secretary Wilkie emphasized the contract’s relationship with Cerner’s EHR effort at the Department of Defense, known as Military Health System (MHS) GENESIS. The new EHR system is expected to work seamlessly with DOD’s, allowing for easier sharing of patient records and coordination. Beyond coordinating with compatible systems in the future, the statement also emphasized that the VA is working with DOD in the near-term on “to ensure lessons learned at DoD sites will be implemented in future deployments at DoD as well as VA.”

Those lessons learned came in the form of an April 30th report from the Director of Operational Test and Evaluation (DOT&E). The report, based on a partial “Initial Operational Test and Evaluation (IOT&E) of 3 out of 4 MHS Genesis sites at treatment centers in Washington State, concluded that “MHS GENESIS is neither operationally effective nor operationally suitable.” Three figures from the report stand out:

• “Users satisfactorily performed only 56 percent of the 197 tasks used as measures of performance.”
• “Users gave MHS GENESIS usability an average score of only 37 out of 100 on the System Usability Scale (SUS), well below the threshold of 70 that indicates acceptable usability.”
• “Users from the four initial sites submitted 14,383 help desk tickets from January to November 2017, overwhelming the help desk’s ability to resolve them.”

The reporting office is giving the fourth MHS GENESIS test site time to remediate issues discovered at the first three before testing it sometime in this fiscal year. Only a few weeks before the report on problems with MHS GENESIS, it was announced that the Coast Guard would join the program after experiencing it’s own difficulties in prior EHR contracts.

Only a day after the Cerner contract announcement, President Trump announced his intentions to nominate Wilkie to permanently run the VA.