Despite dry ink on a $10 billion contract between the Veterans Affairs Department and Cerner, concerns about the project persist.
Some of those concerns stem from the Department of Defense's own Cerner electronic health record project, MHS Genesis, which is struggling with functionality as it's gradually rolled out, a process that begin in 2017.
"VA and DoD are collaborating closely to ensure lessons learned at DoD sites will be implemented in future deployments at DoD as well as VA," said VA acting secretary Robert Wilkie, who on Friday, was tapped to permanently lead the agency.
The VA chose Cerner in part because the DoD is on a Cerner system too, which will allow for interoperability between the two agencies. "Patient data will be seamlessly shared between VA, DoD, and community providers," Wilkie said in the statement.
But without a fully functional DoD system, it's unclear how that would happen. "MHS Genesis is neither operationally effective nor operationally suitable," wrote Robert Behler, the DoD's director of operational test and evaluation, in a recent report. Users could complete only just over half of the tasks used to measure performance, according to the report.
These users also wondered whether information exchanged between MHS Genesis and external systems was accurate and submitted 22 high-severity incident reports related to interoperability.
Such broad functionality problems are somewhat unprecedented in EHR implementations, though the DoD project is much more complicated than a single hospital going live on new software, since the system is so expansive, with 55 hospitals and more than 350 clinics.
"I find the details of these reports to be disturbing and absolutely unacceptable," said Rep. Tim Waltz (D-Minn.), a ranking member in the House Committee on Veterans' Affairs, in a statement. "The root cause of these issues must be identified and remedied before VA implementation can move forward."
Interoperability has dogged the VA-Cerner contract for months. Former VA Secretary Dr. David Shulkin paused contract negotiations until the Mitre Corp. conducted an assessment that included interoperability provisions.
But Cerner executives were optimistic about potential data sharing under the new system. The contract will allow the company and the VA to "create one longitudinal health record with the [DoD], with a goal of providing a seamless care experience for our nation's veterans," according to a Cerner tweet.
Implementation will take about 10 years, according to the VA.
Such a lengthy timeline is necessary, said Dr. Phil Roe (R-Tenn.), chairman of the House Committee on Veterans' Affairs in a statement. "Oversight of implementation and spending will be critical as this process continues," he said.
The market was kind to Cerner the morning after the company made the announcement, with stocks up slightly. Canaccord Genuity analysts expressed "confidence" in the company's 2018 guidance given the signed contract.
Still, uncertainty remains. "Given the controversy with VA leadership and recent articles regarding the IT program, we expect that there will be questions and a media response to this announcement," according to the firm.