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| Image: FCW.com
Editors Note: Cerner was determined to be the sole source for this requirement because they are running the current system for the Military and after billions in historical failures to connect the VA records system to the military, the military and the VA jointly decided to move the entire VA records system over from its current hosting to the military software. This company thus became the sole source and competition was waived. For further details please see: https://rosecoveredglasses.blogspot.com/2018/06/the-next-10-billion-tax-payer-chapter.html
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MILITARY.COM“
“This won’t be easy,” the prime contractor said of the $16 billion effort to overcome decades of failure and finally make veteran and military health records compatible with a few computer clicks.
We must deploy to 117 sites, train over 300,000 VA employees, collaborate with DoD, interoperate with the community, aggregate decades of clinical data and update technology,” he told a hearing of the House Veterans Subcommittee on Technology. “
“It carries risk, and we don’t take the challenges lightly” in implementing Electronic Health Record Modernization (EHRM) programs across the Departments of Veterans Affairs and Defense”, said Travis Dalton, president of government services for Cerner Corp. of Kansas City.
In addition, the new system will have to link with additional community health care providers expected to come onboard with the June 6 rollout of the VA Mission Act, which will expand private health care options for veterans, said Rep. Jim Banks, R-Indiana, the ranking member of the subcommittee.
“Interoperability with the community providers is still the elephant in the room,” he said.
About 30% of veterans currently get health care at taxpayer expense in the private sector, and they “rightfully expect their records to follow them,” Banks said. He said his main concern is that a “half-baked system” will be rushed into use.
Rep. Susie Lee, D-Nevada, chairwoman of the subcommittee, said that Cerner and partners Leidos and Booz Allen Hamilton are attempting to create “one seamless lifetime record for our service members as they transition from military to veteran status,” but “this effort also has the potential to fail.”
“The VA unfortunately does not have a great track record when it comes to implementing information technology,” she said, “and it threatens EHRM.”
Previous attempts to mesh VA and DoD records have either failed or been abandoned, most recently in 2013 when then-Defense Secretary Leon Panetta and then-VA Secretary Eric Shinseki dropped an integration plan after a four-year effort and the expenditure of about $1 billion.
“This won’t be easy, but it is achievable and we are making progress” in the overall effort to let “providers have access to records wherever they deliver care,” Dalton said.
Jon Scholl, president of the Leidos Health Group and a Navy veteran, said the example to follow is the MHS Genesis system, the new electronic health record for the Military Health System. “MHS Genesis is the solution,” he said at the hearing.
However, Lee said that “a suitable single management structure has yet to emerge” for EHRM since then-Acting VA Secretary Robert Wilkie awarded a $10 billion, 10-year contract to Cerner in May 2018. The cost estimate for the contract has since risen to $16 billion.
At a hearing last month of the House Defense Appropriations Subcommittee, Acting Defense Secretary Patrick Shanahan was challenged on the DoD’s efforts to work with the VA on EHRM.
“I don’t ever recall being as outraged about an issue than I am about the electronic health record program,” Rep. Kay Granger, R-Texas, told him.
“Personally, I spend quite a bit of time on how do we merge together” with the VA on the records, Shanahan assured her.
He said pilot programs on making the records compatible are underway in Washington state at Joint Base Lewis-McChord, Naval Base Kitsap, Naval Air Station Whidbey Island and Fairchild Air Force Base.
The “rollout and implementation” of the fix to the electronic health records has shown promise at those installations, Shanahan said, adding that the next step is to put the programs in place at California installations in the fall.”
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Showing posts with label VA Systems. Show all posts
Showing posts with label VA Systems. Show all posts
Friday, June 28, 2019
Sole Source Contractor With Non-Competitive $16 Billion VA Records Integration Contract Calls It “Immense Challenge”
Monday, October 01, 2018
Who’s Really Accountable For Interoperability Between DOD And The VA On E-health Records System?
“FEDSCOOP”
“The departments of Defense and Veterans Affairs both have billion-dollar modernizations in progress for their electronic health record systems. And they’ve each identified who is accountable for the success of those programs.
But the more important question might be: Who is ultimately accountable for seeing that the EHR systems, when fully developed, work together seamlessly as members of the military retire and becomes veterans?”
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“House lawmakers pressed this point this week during the first hearing held by the Veterans Affairs’ Subcommittee on Technology Modernization. They examined the role of the DOD/VA Interagency Program Office (IPO), stood up in 2008 for the exact purpose of ensuring seamless transfer of records. So far, though, that office has no real authority over the interoperability of the two programs —VA’s EHR Modernization and DOD’s MHS GENESIS, both of which are based on Cerner’s commercial EHR platform.
Lauren Thompson, the head of the office, told lawmakers that despite the intention of the 2008 National Defense Authorization Act to make the IPO the single point of accountability for the interoperability of the two departments’ EHRs, “at this point in time, we make recommendations. We do not have the decision-making authority.” IPO is based within DOD.
According to the law, said Carol Harris, director of IT management issues for the Government Accountability Office, “the IPO is supposed to be the single point of accountability. So that would include responsibility, authority and decision-making responsibilities. I think that [the office’s current operation, as described by Thompson], is in conflict with the expectation set out by law.”
The departments and the IPO are trying to sort out the interoperability governance now that VA and DOD each has a massive EHR in development. Though they both are developing instances of the same Cerner platform so that interoperability will be easier to achieve, there are still myriad technical and functional decisions that must align so that the data ultimately matches as it flows from one system to the next. VA, DOD and the IPO are in the process of developing new governance bodies and a new structure with the hope that things can be dealt with at the lowest level possible.
“Clinicians talking to clinicians, technicians talking to technicians,” said John Windom, VA’s acting chief health information officer and program executive officer for the new Office of Electronic Health Record Modernization. When disagreements happen, the issues are elevated to new governance boards, but the goal is to avoid that, he said.
Windom explained that the governance process is “evolving,” and it will take time to get there. “The as-is state of the enterprise with the VA is different than the as-is state of the enterprise within DOD. … Now we’re understanding the gaps between how we sought to implement and how DOD is implementing. And so those gaps have to be reconciled, and they have to be reconciled through governance.”
But even with that model, lawmakers were unhappy because there is no single person or organization accountable. “There’s really no one there to break the ties or resolve the differences,” Rep. Scott Peters, D-Calif., said, pushing for action from the president or Congress to spark the change. “The only person both agencies report to now is the president of the United States.”
Rep. Mike Coffman, R-Colo., said perhaps there’s a place for the IPO in the process, but either the DOD or VA should be given the ultimate decision-making authority.
Harris agreed that a “single executive-level entity that is the point of accountability” with decision-making authority and that binds both departments at the deputy secretary level or higher is “essential.”
She doesn’t have much faith in the IPO, though, at least in its current form — and really for no fault of its own.
“They never had to clout to mediate and resolve issues between DOD and VA,” Harris said. “The IPO was never set up to succeed there because neither of the departments were willing to relinquish control.”
Harris called the IPO’s ability to drive the necessary interoperability “lackluster” in the past decade. “In the past situations, what we’ve seen historically is that when everyone is responsible, no one is responsible. I think that’s what has led us to where we are today,” she said. “Accountability has been so diffused so that when the wheels fall off the bus, you can’t point to a single entity who’s responsible. And that’s a problem.”
https://www.fedscoop.com/dod-va-ehr-interoperability-hearing/
“The departments of Defense and Veterans Affairs both have billion-dollar modernizations in progress for their electronic health record systems. And they’ve each identified who is accountable for the success of those programs.
But the more important question might be: Who is ultimately accountable for seeing that the EHR systems, when fully developed, work together seamlessly as members of the military retire and becomes veterans?”
________________________________________________________________________
“House lawmakers pressed this point this week during the first hearing held by the Veterans Affairs’ Subcommittee on Technology Modernization. They examined the role of the DOD/VA Interagency Program Office (IPO), stood up in 2008 for the exact purpose of ensuring seamless transfer of records. So far, though, that office has no real authority over the interoperability of the two programs —VA’s EHR Modernization and DOD’s MHS GENESIS, both of which are based on Cerner’s commercial EHR platform.
Lauren Thompson, the head of the office, told lawmakers that despite the intention of the 2008 National Defense Authorization Act to make the IPO the single point of accountability for the interoperability of the two departments’ EHRs, “at this point in time, we make recommendations. We do not have the decision-making authority.” IPO is based within DOD.
According to the law, said Carol Harris, director of IT management issues for the Government Accountability Office, “the IPO is supposed to be the single point of accountability. So that would include responsibility, authority and decision-making responsibilities. I think that [the office’s current operation, as described by Thompson], is in conflict with the expectation set out by law.”
The departments and the IPO are trying to sort out the interoperability governance now that VA and DOD each has a massive EHR in development. Though they both are developing instances of the same Cerner platform so that interoperability will be easier to achieve, there are still myriad technical and functional decisions that must align so that the data ultimately matches as it flows from one system to the next. VA, DOD and the IPO are in the process of developing new governance bodies and a new structure with the hope that things can be dealt with at the lowest level possible.
“Clinicians talking to clinicians, technicians talking to technicians,” said John Windom, VA’s acting chief health information officer and program executive officer for the new Office of Electronic Health Record Modernization. When disagreements happen, the issues are elevated to new governance boards, but the goal is to avoid that, he said.
Windom explained that the governance process is “evolving,” and it will take time to get there. “The as-is state of the enterprise with the VA is different than the as-is state of the enterprise within DOD. … Now we’re understanding the gaps between how we sought to implement and how DOD is implementing. And so those gaps have to be reconciled, and they have to be reconciled through governance.”
But even with that model, lawmakers were unhappy because there is no single person or organization accountable. “There’s really no one there to break the ties or resolve the differences,” Rep. Scott Peters, D-Calif., said, pushing for action from the president or Congress to spark the change. “The only person both agencies report to now is the president of the United States.”
Rep. Mike Coffman, R-Colo., said perhaps there’s a place for the IPO in the process, but either the DOD or VA should be given the ultimate decision-making authority.
Harris agreed that a “single executive-level entity that is the point of accountability” with decision-making authority and that binds both departments at the deputy secretary level or higher is “essential.”
She doesn’t have much faith in the IPO, though, at least in its current form — and really for no fault of its own.
“They never had to clout to mediate and resolve issues between DOD and VA,” Harris said. “The IPO was never set up to succeed there because neither of the departments were willing to relinquish control.”
Harris called the IPO’s ability to drive the necessary interoperability “lackluster” in the past decade. “In the past situations, what we’ve seen historically is that when everyone is responsible, no one is responsible. I think that’s what has led us to where we are today,” she said. “Accountability has been so diffused so that when the wheels fall off the bus, you can’t point to a single entity who’s responsible. And that’s a problem.”
https://www.fedscoop.com/dod-va-ehr-interoperability-hearing/
Saturday, July 01, 2017
VA Will Shift Medical Records To DOD’s “In-Process” Electronic Medical Records System
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Image: Military TimesTotal Investment To Date Now Projected at Nearly $10 Billion
“MILITARY TIMES”
“VA has already spent more than $1 billion in recent years in attempts to make its legacy health record systems work better with military systems.
The military’s health record system is still being put in place across that department, more than three years after the acquisition process began. The initial contract topped $4.6 billion, but has risen in cost in recent years.
Shulkin did not announce a potential price tag for the move to a commercial electronic health records system, but said that a price tag of less than $4 billion would likely be “unrealistic.”
“Veterans Affairs administrators on Monday announced plans to shift veterans’ electronic medical records to the same system used by the Defense Department, potentially ending a decades-old problematic rift in sharing information between the two bureaucracies.
VA Secretary David Shulkin announced the decision Monday as a game-changing move, one that will pull his department into the commercial medical record sector and — he hopes — create an easier to navigate system for troops leaving the ranks.
“VA and DoD have worked together for many years to advance (electronic health records) interoperability between their many separate applications, at the cost of several hundred millions of dollars, in an attempt to create a consistent and accurate view of individual medical record information,” Shulkin said.
“While we have established interoperability between VA and DOD for key aspects of the health record … the bottom line is we still don’t have the ability to trade information seamlessly for our veteran patients. Without (improvements), VA and DoD will continue to face significant challenges if the departments remain on two different systems.”
White House officials — including President Donald Trump himself — hailed the announcement as a major step forward in making government services easier for troops and veterans.
Developing implementation plans and potential costs is expected to take three to six months.
But he did say VA leaders will skip standard contract competition processes to more quickly move ahead with Millennium software owned by Missouri-based Cerner Corp., the basis of the Pentagon’s MHS GENESIS records system.
“For the reasons of the health and protection of our veterans, I have decided that we can’t wait years, as DOD did in its EHR acquisition process, to get our next generation EHR in place,” Shulkin said.
Shulkin for months has promised to “get VA out of the software business,” indicating that the department would shift to a customized commercial-sector option for updating the health records.
The VA announcement came within minutes of Trump’s controversial proposal to privatize the nation’s air traffic control system. The president has repeatedly pledged to make government systems work more like a business, and in some cases hand over public responsibilities to the private sector.
Shulkin has worked to assure veterans groups that his efforts to rely on the private sector for expertise and some services will not mean a broader dismantling of VA, but instead will produce a more efficient and responsive agency.
He promised a system that will not only be interoperable with DOD records but also easily transferable to private-sector hospitals and physicians, as VA officials work to expand outside partnerships.
Shulkin is expected to testify before Congress on the fiscal 2018 budget request in coming weeks. As they have in past hearings, lawmakers are expected to request more information on the EHR changes then. ”
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