Cerner wins Veterans Affairs EHR contract without competitive bidding process

Confirming months of speculation, Cerner has been selected to replace the U.S. Department of Veterans Affairs’ in-house electronic health record system.

The announcement from VA Secretary David Shulkin, MD, came before the July 1 deadline the department had set for deciding on the future of the Veterans Health Information Systems and Technology Architecture (VistA). Shulkin praised the work by clinicians who have worked on the system since the 1970s, but said “major modernization” was needed, with a commercial product better suiting the VA’s needs than developing new software on its own.

A key factor in the decision to pick Cerner was its existing contract with the U.S. Department of Defense (DoD). Improved interoperability still hasn’t been achieved between the two departments—despite $564 million being spent on such efforts—and Shulkin felt the best option was for the VA to adopt the same MHS Genesis platform as the DoD.

“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,” Shulkin said at a June 5 news briefing.

Cerner had been identified as the likeliest EHR vendor for the VA before it officially decided to go to a commercial product. This selection, however, is noticeably different from how Cerner won the DoD’s business. There will be no competitive bidding process, which Shulkin said would take up to 26 months, and he gave no estimate of what the Cerner contract may cost.

“We have not agreed upon any pricing, but I can assure you that before we were to sign off on a contract, we are going to make sure that this is the best value for taxpayers,” Shulkin said.

Bypassing a bidding war will be better for veterans, Shulkin said, so he signed what is known as a “Determination and Findings,” or D&F form, which allows for “public interest exceptions” to the federal acquisition process.

Shulkin cautioned that the implementation wouldn’t be rushed, saying VA clinicians will be consulted on the new system, which won’t be “the identical EHR” as the DoD, but will run on a similar platform. Interoperability with the DoD and the VA’s academic affiliates and community partners will also be a priority.

The selection was praised by President Donald Trump, who believed it would result in “faster, better and far better quality care for veterans.” Advocacy group Paralyzed Veterans of America, however, offered tepid support, saying it was “cautiously optimistic” about the new system but concerned about adequate funding from Congress.

"Technological integration of DOD, VA and community sector care is a tremendous undertaking that could vastly improve patient care," said the group’s associate executive director of medical services, Lana McKenzie, RN, MHA,. "Timely access to patient data translates into timely diagnosis and timely treatment, so it is a critical component to patient care. If it comes to fruition, the new system could positively impact veteran healthcare for future generations.”

In its own statement, Cerner said the new system will be beneficial for VA patients.

"We believe this project, in concert with ongoing progress towards implementing the Department of Defense’s MHS Genesis system, will lead to ongoing innovation, improved interoperability and the creation of a single longitudinal health record that can facilitate the efficient exchange of data among military care facilities and the thousands of civilian health care providers where current and former service members receive healthcare,” the company said.