As the Department of Veterans Affairs looks to finalize its contract with Cerner, the agency has laid out some comprehensive expectations for the EHR vendor that emphasize change management and interoperability.
Documents released by the VA last week outlined some specific requirements for Cerner, which was tapped to overhaul the agency's EHR system in June. The rollout is expected to cost at least $10 billion and is poised to consume the next decade.
Last week, Politico reported that the final contract, which VA officials expected to complete by the end of November, was held up because of lingering interoperability concerns from Secretary David Shulkin, M.D.
Unsurprisingly, interoperability and data exchange make up a significant part of the VA’s focus. A performance work statement (PWS) finalized by VA officials in October states that the EHR system will “become the authoritative source of clinical data” for the 168-hospital system to support "improved population health, patient safety, and quality of care provided by VA.” Although the impetus of the sole-source contract was to better align the VA with the Department of Defense, the agency clearly expects Cerner to improve information exchange with community health providers.
The PWS features specific requirements for Cerner, including an interoperability plan delivered to the VA each year. At minimum, Cerner’s solution must be able to do the following:
- Allow the VA to release and consume a veteran’s “complete longitudinal health record” with DOD and community partners
- Share interactive care plans
- Share URL-based images with community and academic partners' systems
- Connect with interoperable networks like eHealth Exchange, CareQuality, CommonWellHealth Alliance, Direct Trust and the National Association for Trusted Exchange
- Allow providers to collaborate via secure email within the EHR workflow.
Within two years of awarding the contract, the VA also expects Cerner to:
- Connect with the DOD and community providers to provide a referral management solution
- Notify providers when a veteran is admitted, discharged or transferred
- Identify and manage veterans at a high risk for suicide.
The VA also referenced its “digital health platform/digital veteran’s platform,” a project that has been in the works for several years. The agency calls on Cerner to “work in good faith” to integrate EHR data into the platform, including through an “API gateway.”
The PWS makes numerous references to organizational change management, an issue that Shulkin has repeatedly emphasized as a critical aspect of the EHR deployment. The VA wants Cerner to provide localized and national change management strategy using credentialed clinicians, change management specialists and project managers.
The PWS states that Cerner will also be responsible for identifying change management “hot spots" and pain points that might hinder adoption, and conduct site assessments to determine readiness.