The US Department of Veterans Affairs agency will replace its ageing electronic health record system, called VistA, by adopting the same Cerner platform as the US Department of Defense.

The decision came with news that the VA had decided for public interest reasons to set aside usual competitive procurement rules and instead directly solicit Cerner to acquire the DoD’s EHR system.

The VA, which has been the champion of open source EHR development for over 30 years, will now move to the same vendor as DoD, VA Secretary David Shulkin said in a statement.

Shulkin had first hinted in March that the VA would move from in-house EHR development to a commercial product, noting the software development business “is not a core competency for the agency”.

Announcing the decision on Monday President Trump said that the choice of a new EHR, will fix the agency’s data sharing ‘once and for all’.

“The records will now be able to follow the veteran when they leave service, meaning faster and far better quality care. This is one of the biggest wins for our veterans in decades and I congratulate Secretary Shulkin for making this very important decision,” Trump said.

The decision to move to Cerner forms part of ongoing effort by the VA to modernise its healthcare IT system, and a government drive for closer integration between DoD and the VA.

The US DoD awarded a contract to Leidos and Cerner for its healthcare facilities, which after delays, began roll-out earlier this year to the Military Health System, with full roll-out scheduled to be completed by 2022.

Significant efforts and investment have already been channelled into enabling interoperability between the DoD and Veterans Health Administration, but these are not felt to go far enough in integrating patient care, “the bottom line is we still don’t have the ability to trade information seamlessly for our Veteran patients and seamlessly execute a shared plan of care with smooth handoffs,” said Shulkin.

“Without improved and consistently implemented national interoperability standards, VA and DoD will continue to face significant challenges if the Departments remain on two different systems,” said Shulkin. “For these reasons, I have decided that VA will adopt the same EHR system as DoD, now known as MHS GENESIS, which at its core consists of Cerner Millennium,” Shulkin wrote.

He explained that usual procurement rules had been set aside to avoid a lengthy procurement, which for the Military Health System had taken 24-months: “For the reasons of the health and protection of our veterans, I have decided that we can’t wait years, as DoD did in its EHR acquisition process, to get our next generation EHR in place.”

By the VA adopting the same Cerner EHR system as DoD all patient data will reside in one common system and enable seamless care between the departments, Shulkin said.

Because the VA has different needs to the DoD, particularly the need to share information with a range of other healthcare organisations running on different systems, the agency will not adopt an identical version of the Cerner EHR used by DoD.

The open source Veterans Health Information Systems and Technology Architecture (VistA), has been developed since in the 1970s. VistA currently serves more than 1,200 healthcare sites of the Veterans Health Administration throughout the US, but was been judged by the DoD to be outdated and unable to meet changing needs.

Shulkin praised the huge achievements of the VA in developing VistA, and benefits this had brought to many patients, and noted: “In many ways VA is well ahead of DoD in clinical IT innovations and we will not discard our past work.”

“That said, our current VistA system is in need of major modernisation to keep pace with the improvements in health information technology and cybersecurity, and software development is not a core competency of VA.”

He added: “We have consulted with Chief Information Officers from around the country, and I’ve met personally with CEO’s from leading health systems to get their own thoughts on the best next-generation EHR for VA.

“I can count no fewer than 7 Blue Ribbon Commissions, and a large number of congressional hearings that have called for VA to modernise its approach to IT”.


Press Conference of VA Secretary David Shulkin, MD, explaining the decision to switch from VistA to Cerner