Cerner Corp. has scored another government contract for its electronic health record, which could eventually help streamline access to EHRs for all military beneficiaries and retirees.
The U.S. Coast Guard recently announced it will move to Cerner's EHR and join the Defense Department in the MHS Genesis project, according to a Defense Healthcare Management Systems notice of intent.
The streamlining benefits of the move depend in part on whether the Veterans Affairs Department's stalled contract with Cerner goes through and how it's executed. Quibbles about interoperability and the recent departure of Dr. David Shulkin as VA secretary have hamstrung progress on the contract.
It's unlikely the Coast Guard's move will spur the VA into action with Cerner, said Dr. Nancy Anthracite, president of WorldVistA, a not-for-profit that promotes the use of an open-source version of the VA's homegrown EHR. "The Coast Guard is small enough that I don't think it would change anything about what the VA is doing," she said.
The Coast Guard has been using paper records since ending its $14 million Epic implementation in 2016.
The MHS Genesis project contract currently stands at $4.3 billion, but could grow.
"It makes a lot of sense that the Coast Guard would want to emulate or piggyback off of the DoD's implementation of a Cerner product," said Dr. David Kibbe, president and CEO of DirectTrust. "The Coast Guard is probably saying that the kinks will be worked out by the DoD and by the time it gets to us, we'll have a smoother implementation cycle."
But there's less similarity between the Coast Guard and the VA than there is between the Coast Guard and the Defense Department, Kibbe pointed out. Both the Coast Guard and Defense Department tend to treat active-duty—and therefore younger—patients, while the VA's patients skew older. The actual EHRs put in place at the VA and Defense Department may end up being quite different.
The VA's no-bid contract with Cerner has been sitting in limbo since it was first announced in mid-2017.
"There's a lot of tension in the VA right now around this decision," Kibbe said. "There's always been a group in the VA who wanted Vista to persist and be updated and to not go with any private-sector EHR vendor."