"Twenty percent of our system is running on out of date IT. And 75 percent of the IT budget is spent on just maintenance. Our legacy systems are old and crippling, while our schedule and maintenance systems are outdated."
In March of 2018 Shulkin resigned after the Inspector General reported that Shulkin was "improperly accepting gifts, misrepresenting travel plans, and using a VA worker for personal travel." Anyway, regardless of the corruption---
On May 18, 2018 the VA signed a no-bid $10 billion contract with Cerner. Cerner is the same system that Trump's Department of Defense gave a $4.3 billion no-bid contract to for an EHR-system, and it has been a disaster implementing. Cerner has already had 60% in price overruns for VHA, and it has not even started. The original no-bid price tag has gone from $10 billion to $16 billion.
In explaining the price overrun, Executive Director of the federal government's Office of Electronic Health Record Modernization John Windom told Congress that:
"We have to have highly qualified subject matter experts to grade the implementation efforts of Cerner. Those people in the industry cost money."
In other words, kaching-kaching, it is going to take years, many snafus and big cost overruns to get Cerner up and running. The target date for a pilot program of Cerner is March of 2020, but don't hold your breath or your wallet.
In July 2019, VHA announced that it would have to spend another $5 billion to transition VistA to Cerner:
"As the nationwide Cerner rollout progresses, VA will decommission VistA instances as necessary,"
Dr. Paul Tibbits, executive director of the office of technical integration in the VA's office of information and technology said at a hearing, adding:
"During the transition period VA must maintain VistA to ensure current patient-record accessibility and continued delivery of quality of care."
In 2019, the VHA reported to the GAO that from 2015 to 2017, the marginal cost of operating VistA was only $2.3 billion. That is a big difference than the tens of billions of dollars being churned by the appropriately named Cerner. The lower cost to VHA for VistA was because it is internally maintained.
For a fraction of the cost of Cerner, VistA could be updated. It could also join the international initiative to take VistA international. Can you imagine the advantages of being able to go anywhere in the world and healthcare providers have access to all of you medical records if needed?
Yep, as noted above, John Windom said about Cerner:
"Those people in the industry cost money".
They sure do, and Niam Yaraghi of the Brookings Institution predicts that Cerner will be a failure:
"VHA's legacy EHR system, VistA, has been ranked amongst the best EHR system by physicians. VHA was the pioneer of patient-mediated exchange solutions: their [My HealtheVet] Blue Button technology allows consumers to access a single, downloadable file with their available health data. It is disappointing to see VA adopting outdated solutions [Cerner] while the rest of the industry is finally implementing the exchange solutions [My HealtheVet] invented by VA many years ago."
My HealtheVet is another information technology invented by the VHA. It was launched in 2003 by VHA so that veterans can access VHA services and their medical records online by interfacing with VistA.
My HealtheVet empowers veterans to be proactively involved in their healthcare. In 2018, My HealtheVet received the Top Public Sector Innovation Award.
With My HealtheVet, a veteran can get all of his medical records online. He can review his appointments, make and cancel appointments, send and receive messages with any of his doctors. He can contact all the departments of VHA, order prescription refills, add non-VA medicines to his records, and keep all sorts of healthy living and preventive healthcare journals.
With My HealtheVet, a veteran can share all of his medical records with trusted family and guardians, and with non-VHA health providers. So, no matter where in the world a veteran may be, he can access his medical records for himself or for a non-VHA healthcare provider.