The VA, which pioneered the electronic health record (EHR) system with the in-house development of VistA, will adopt a new EHR system based on the DoD’s MHS Genesis. “VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the Departments without the manual and electronic exchange and reconciliation of data between two separate systems,” Secretary of Veteran Affairs David J. Shulkin, MD, explained in a press briefing.
To expedite the process, Dr. Shulkin issued a Determination and Findings, which allows the VA to circumvent the normal acquisition procedures and move forward more quickly. According to Dr. Shulkin, it took the DoD more than 2 years to complete the acquisition process. The MHS Genesis EHR system is based on the Cerner Millennium database. “It’s time to move forward, and as Secretary I was not willing to put this decision off any longer,” Dr. Shulkin said.
The move away from VistA and toward closer integration with the DoD has been a long time in coming. VistA was one of the first EHR systems, but the VA has struggled in recent years to maintain the system. It has been nearly 2 decades since Congress first asked VA and DoD to work more closely together, but integration of the 2 health systems has been expensive and incomplete.
“While we have established interoperability between VA and DoD for key aspects of the health record, seamless care is fundamentally constrained by ever-changing information sharing standards, separate chains of command, complex governance, separate implementation schedules that must be coordinated to accommodate those changes from separate program offices that have separate funding appropriations, and a host of related complexities requiring constant lifecycle maintenance,” Dr. Shulkin explained.
President Trump expressed his support for the move in a tweet.
Even with the expedited acquisitions process, the process should still take 3 to 6 months to develop the specifications and determine the costs of the major technology overhaul. The DoD contract with Cerner is $4.3 billion, and the VA contract is expected to be larger. DoD officials involved in the MHS Genesis implementation will work with the VA, Dr. Shulkin noted, allowing the VA to leverage their experience in the EHR roll out.
