"This won't be easy," the prime contractor said Tuesday of the $16 billion effort to overcome decades of failure and finally make veteran and military health records compatible with a few computer clicks.
"This undertaking is immense. 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.
"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.
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.
-- Richard Sisk can be reached at Richard.Sisk@Military.com.
