VA’s EHR contract pause, lack of permanent CIO draw scrutiny in Senate

David Shulkin testifies before the Senate Veterans Affairs Committee in September 2017. (VA photo)

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A key senator has grown impatient with the Department of Veterans Affairs’ progress in finalizing its contract to procure a modernized electronic health record as well as its sluggish pace to hire a permanent CIO.

The VA announced in June it would contract for a commercial off-the-shelf EHR modernization through Cerner so that the end product would be interoperable with the Defense Department’s system-in-progress, also based on a Cerner system. But in December, VA Secretary David Shulkin announced the department would miss a self-imposed deadline to finalize contract negotiations with Cerner, putting the process on pause while the VA explores some lingering questions.

The No. 2 Republican on the Senate Veterans’ Affairs Committee, Jerry Moran of Kansas, is questioning the impact the delay could have on the success of the program’s eventual implementation. He brought it up in a committee hearing Wednesday and in a letter to Shulkin sent the day prior. It’s worth noting that Cerner is headquartered in Kansas City, Mo., just outside of Moran’s home state.

In prepared testimony, Shulkin explained that the sudden but “strategic” stop came as VA decided “to conduct an additional and external assessment of national interoperability language contained in the Request for Proposal that would ultimately support an EHR contract award.” The department enlisted the MITRE Corp. to lead the research, which he wrote should be sent to him and reviewed by the end of the month.

If the contract isn’t finalized this month, Moran wrote, the VA will put the program at serious risk of derailing its early implementation, and the savings and efficiencies that would otherwise come from a timely launch.

“[F]urther delay disrupts your implementation plan that requires 900 Cerner IP engineers to support the VA’s deployment of the system in the Pacific Northwest,” reads the letter, which his staff sent to FedScoop. “Unless you finalize the contract this month, there will be a considerable shift within Cerner to reassign there 900 IP engineers to other projects, which will be difficult to reset or recommit to this contract in the future.”

“It is unclear how you intend to mitigate deviations from the VA’s plan developed with Cerner,” he wrote.

VA officials made it clear at a House hearing last November that they were moving quickly to finalize the contract and start implementation in the same regions, starting in the Pacific Northwest, the DOD was launching its EHR so VA could best leverage its early lessons and avoid common pitfalls. The DOD itself isn’t without road bumps — the department this week decided to halt further rollout of MHS GENESIS for at least eight weeks to work on thousands of issues with the pilots.

Moran seemed in the hearing and letter to take most issue with the discrepancies in what Shulkin and his team testified in November, and the course they’ve since taken — something the senator attributed in Wednesday’s hearing to the VA leader’s “ability to speak out of both sides of [his] mouth.”

“This pattern of equivocation, on the new electronic health record system and other VA matters of significance, is frustrating,” he also said in the letter.

The committee’s impatience Wednesday also extended to Shulkin’s seeming lack or urgency to permanently fill many key deputy leadership positions, including VA’s CIO role.

When asked about it, Shulkin explained though that a permanent CIO pick could be coming soon.

“For the CIO candidate, we have made a selection, and that person is now going through a vetting process at the White House,” he said, giving no further details on whether VA’s selection would be a new hire from outside the agency or someone already serving at the department. “Our indications are that that is moving along smoothly.”

Scott Blackburn, who was formerly executive director of the MyVA Task Force and promoted earlier this year to serve as interim deputy secretary, has been serving as acting CIO since September. But it’s been a year now since the VA has had a permanent, senate-confirmed CIO, a void left after LaVerne Council left the position in January 2017 at the end of the Obama administration.

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Cerner, David Shulkin, Department of Veterans Affairs, DOD, EHR, health, Jerry Moran, VA