WASHINGTON – The Department of Veterans Affairs signed a multibillion-dollar contract on Thursday to replace its antiquated electronic health record system – an action that comes as a relief to veterans and lawmakers who worried it was indefinitely stalled after former VA Secretary David Shulkin was fired in March.
The contract with Kansas City, Mo.-based Cerner Corp. sets a cost ceiling of $10 billion for the next 10 years. In a statement Thursday, acting VA Secretary Robert Wilkie described it as “one of the largest [information technology] contracts in the federal government.”
“And with a contract of that size, you can understand why former Secretary Shulkin and I took some extra time to do our due diligence and make sure the contract does what the president wanted,” Wilkie said.
Shulkin announced last summer the VA would award a contract to Cerner to overhaul its electronic health records, side-stepping the federal contracting process to do so. It will replace its in-house system, VistA, with MHS Genesis, the same system used by the Defense Department.
The overhaul is intended to allow medical records for transitioning servicemembers to be shared immediately with the VA. The VA also will be able to easily share information with private-sector providers who treat veterans, Wilkie said.
The deal is years in the making.
Since 2000, lawmakers have advocated for a system capable of sharing patient data seamlessly with the Defense Department. Soon after former President Barack Obama took office in 2009, he charged the VA and Defense Department with creating an integrated system. The plan was abandoned in 2013 because of cost concerns, after the agencies had already spent about $1 billion.
Last year, the Government Accountability Office criticized the VA for continuing to spend billions of dollars to patch the 40-year-old VistA. The GAO described the system as “old, inefficient and difficult to maintain” and encouraged the VA to buy an off-the-shelf health records system.
Shulkin championed the idea. When he was fired March 28, veterans and advocates grew worried that a contract wouldn’t be signed. Those concerns grew April 17, when Scott Blackburn, the VA’s chief information officer, resigned. Concerns reached an all-time high April 30, when Politico reported a West Palm Beach doctor with ties to Trump was influencing contract negotiations.
Politico reported Dr. Bruce Moskowitz was included in phone calls with the contracting team. He objected to the contract because he doesn’t like Cerner Corp. software.
In response, lawmakers called for more oversight of contract negotiations. Two representatives on the House Committee on Veterans’ Affairs – Reps. Julia Brownley, D-Calif., and Annie Kuster, D-N.H. – asked Wilkie and VA Inspector General Michael Missal investigate the delays. More Democrats signed onto a letter Tuesday describing the lack of progress on the contract as “malign neglect.”
Wilkie indicated Thursday that the timeline slowed only because the VA was acting deliberately and wanted the contract to be well thought out.
“President [Donald] Trump has made very clear to me that he wants this contract to do right by both veterans and taxpayers, and I can say now without a doubt that it does,” he said.
Rep. Phil Roe, R-Tenn., the chairman of the House Committee on Veterans’ Affairs, said he spoke with Wilkie about the contract Thursday and was “encouraged by our conversation.”
“This transition should be done right, not fast, and I’m pleased the department took extra time to review the contract before moving forward,” he said.
Roe and other lawmakers stressed the importance of congressional oversight while the VA and Cerner work to implement the new system.
As recently as Monday, the Defense Department cited problems with Cerner’s work to roll out that agency’s new electronic health record. The Defense Department’s director of operational test and evaluation released a report stating the agency’s electronic health record implemented at multiple DOD sites is “neither operationally effective nor operationally suitable.”
Wilkie said the VA would collaborate with the Defense Department about "lessons learned" from DOD’s rollout of its electronic health record.
“The root cause of these issues must be identified and remedied before VA implementation can move forward,” Rep. Tim Walz, D-Minn., said in a written statement. Walz is the ranking Democrat on the House Committee on Veterans’ Affairs.
Walz and Sen. Jon Tester, D-Mont., the ranking Democrat on the Senate Veterans’ Affairs Committee, also expressed concerns with the capability of VA leadership to establish the new system.
On Tuesday, Democrats demanded the VA fire its new acting chief information officer, Camilo Sandoval, who served as the data operations director for Trump’s presidential campaign. The Trump administration has recently come under scrutiny for consulting with Cambridge Analytica during the 2016 presidential campaign because the data firm harvested Facebook users’ personal information.
“Cambridge Analytica’s misuse of personal information from tens of millions of Americans, including veterans, was an incredible breach of trust,” the Democrats wrote to VA Deputy Secretary Thomas Bowman. “As such, Mr. Sandoval’s role in these activities must be thoroughly examined and he should be put nowhere near veterans’ health and benefits data.”
Tester vowed Thursday to hold the VA accountable.
“This is the largest electronic health record transformation in the history of American medicine, and the VA has no room for error,” Tester said in a prepared statement. “The VA must make sure it has the staff to manage this project and immediately get qualified nominees to oversee it.”
Last year, Congress authorized $782 million to begin the overhaul of the electronic health record.