Health IT leaders have been eagerly awaiting a multibillion-dollar contract between the Department of Veterans Affairs and EHR vendor Cerner since the agency announced the North Kansas City, Mo.-based supplier would replace its homegrown VistA software in June, but they'll have to wait even longer.
November has come to a close without a publicized contract, meaning VA has missed its self-imposed deadline of early November to strike a deal, in part because Congress has reportedly yet to OK the project's funding.
Here is a breakdown of the saga so far, as reported by Becker's Hospital Review.
March 21: VA Secretary David Shulkin, MD, said he planned to decide whether the VA would move its EHR to a commercial platform in July.
June 5: Ahead of schedule, Dr Shulkin announced Cerner would replace VistA as the agency's EHR. This decision marked the first time VA and the Department of Defense would be on the same EHR. Dr. Shulkin signed a "determination and findings" form for the no-bid decision.
The VA may still keep its contract with Epic, which it signed in 2015 for online medical appointment scheduling. Under the contract, Epic receives $624 million over five years. A pilot had already rolled out. A VA spokesperson told Becker's Hospital Review June 7 there is no connection between the VA's existing contract with Epic and the recent Cerner EHR announcement.
June 7: Dr. Shulkin told the Senate Veterans Affairs Committee in a hearing the VA may need "approximately three to six months to come up with a plan [to acquire and implement Cerner EHRs]." His written testimony referenced the Veterans Choice Program Improvement Act, which enables the VA to use $10 billion allocated toward veterans care. However, he did not say how that money would be divided within the VA.
July 13: The Senate Appropriations Committee passed its fiscal year 2018 Military Construction, Veterans Affairs and Related Agencies Appropriations Bill. The bill failed to allocate additional funding for the VA's transition to the Cerner EHR because, according to the committee, Dr. Shulkin's announcement did not provide it enough time to ascertain how the cost of a new EHR will compare to the cost of the agency's current system.
July 31: In a leaked hour-long address to Congressional interns, White House Adviser Jared Kushner said the deal with Cerner is "one of the great successes we've had so far" in reforming the VA. During his remarks, Mr. Kushner detailed how the decision came about, noting he, Dr. Shulkin and Secretary of Defense James Mattis were discussing the VA's EHR during meetings with EHR experts. He said they gave the experts a two-week deadline to solve the VA's EHR issue, which the group accomplished.
Aug. 18: CliniComp, a San Diego-based EHR provider, filed a lawsuit against the VA for its decision to tap Cerner as its systemwide EHR in a no-bid contract. The lawsuit alleged Dr. Shulkin violated federal contracting law by announcing Cerner's contract without first conducting adequate market research.
Sept. 27: Dr. Shulkin told lawmakers VA was on track with his original timeline.
"We released to Congress, to you, a 30-day notice of award of a contract," he said.
He also provided senators an update on the VA's strategic IT plan at a Senate Veterans Affairs Committee hearing that included migrating or halting 240 of the department's 299 ongoing projects. After ending these projects, which comprise 80 percent of the department's IT development portfolio, the VA will shift surplus funding to the EHR project.
Oct. 18: A Court of Federal Claims judge dismissed CliniComp's lawsuit over lack of jurisdiction. However, CliniComp officials later attempted to appeal the decision. In November, CliniComp offered to enter into a settlement with the VA if the agency agrees to review the company's EHR.
Late October: The VA reportedly told Congress its contract with Cerner could be awarded within the first two weeks of November, and its estimated cost would be around $18 billion.
Other sources said the VA and Cerner agreed to a $10 billion price tag, significantly less than previously reported estimates. The Cerner EHR is expected to be implemented across the VA system in 48 phases, including site visits, user training and onsite support.
Nov. 13: Kamal Narang, head of CSRA's Federal Health Group, said the VA had awarded CSRA a $158 million contract to help digitize patient health records before the agency begins its transition to a Cerner EHR. The contract with CSRA, a Falls Church, Va.-based IT company, would task its subsidiary, SRA International, with digitizing more than 7 million veterans' health records over the course of 36 months.
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