In August, 2015, I blogged that Cerner had secured a contract to provide a global EHR to the military (see: Cerner/Leidos/Accenture Secure EHR Contract for a Global Military EHR). At that time, I made the following comment about the deal:
As to Epic "failure" to win the contract, I suspect that there were a lot of smiles of relief in Verona when the winner was announced. I think that Epic was competing in the contest because everyone expected it to do so. The Epic culture and emphasis on client control was probably a non-starter for the military brass. Leidos/SAIC contrariwise was a known quantity for them. Epic has almost a lock on the EHR business for the larger and most prestigious U.S. hospitals and success with a DOD contract would have done little to burnish the company image. It will just keep on rolling, closing more deals in the U.S. and beefing up its international set of clients.
It might have been assumed that Cerner would then be the logical choice to provide an EHR to the VA to replace VistA because of the need for health record continuity for military personnel after they leave active service (see: Comprehensive History of VistA; What's Next for This Early, Highly Functional EHR?). However, there now seems to be a problem. Recent news is that there has been a glitch in contract negotiations between the VA and Cerner (see: VA, Cerner EHR deal held up after spat over interoperability definition) and below is an excerpt from the article:
The U.S. Department of Veterans Affairs’ EHR contract with Cerner was set to be signed this fall, but a new report from Politico found that it’s been held up over disagreements between executives on the definition of interoperability. VA Secretary David Shulkin, MD, selected Cerner in a no-bid contract in June to replace the agency’s legacy VistA EHR as a way to align data between the VA and the Department of Defense, which already runs on Cerner. The contract is estimated at about $10 billion or more....However, Shulkin has pushed back the expected fall deadline, as Cerner’s definition of interoperability was too limited, covering only documents called CCDAs, or Consolidated Clinical Document Architecture.....In December, the VA released its report on the functional requirements expected from Cerner. Not only is Cerner expected to provide a seamless platform between DoD and VA, interoperability must be far better than the industry standard. “The Contractor is required to collaborate with VA affiliates, community partners, EHR providers, healthcare providers and vendors to advance seamless care throughout the healthcare provider market,” according to the work statement. The goal is to enable access and data sharing, along with a security framework to support end-to-end healthcare clinical and business operations.
I am impressed that the VA is talking tough with Cerner on interoperability concerns which has continued to be a weak point in EHRs for a long time (see, for example: Hospitals Need to Pressure Their EHR Vendors to Improve Software Functionality). We will see where this all ends up but, speaking realistically, I don't see any vendor on the horizon that could realistically replace VistA other than Cerner. Probably both parties understand this and the delay won't last too long.