Veterans Affairs Secretary David Shulkin told House appropriators that he expected the agency's adoption of the Cerner electronic health care record to have far reaching effects on the interoperability of the U.S. health system.
VA Secretary David Shulkin and a colleague demonstrate a telehealth app for President Trump at a White House event. (VA photo)
Veterans Affairs Secretary David Shulkin told House appropriators on March 15 that he expected the agency's adoption of the Cerner electronic health care record to have far reaching effects on the interoperability of the U.S. health system.
At a hearing of the House Appropriations subcommittee that funds the Department of Veterans Affairs, Shulkin said that a "pause" on the Cerner contract and a MITRE review of interoperability with other commercial systems generated 51 recommendations that are being built in to the contract.
The VA updated its public-facing contracting documents with new requirements on March 15. Those new requirements are based on the MITRE recommendations, a VA source told FCW.
The biggest change is pushing against the proprietary culture of the electronic medical records industry, in which data is horded and shared on a fee basis.
"We've said to Cerner that we are not going to sign a contract that's going to allow proprietary protection and information blocking to continue," Shulkin said. He said the Cerner-VA contract, when it is signed, will be "groundbreaking" in that respect.
VA is pushing for national interoperability among community systems by asking health systems to take a "pledge" to share data without regard to intellectual property rights using open application programming interfaces – giving individuals and institutions greater access to patient data. So far, 11 major hospital systems have signed on to the pledge.
With open APIs and common non-proprietary standards, Shulkin said, "you're now breaking open interoperability in a way that's not been done before."
VA has launched its own internal effort dubbed Lighthouse to try to seed a developer community to build applications using data from VA APIs.
"We're going to change care not only for veterans, but across the country for all Americans," Shulkin said.
Rep. Debbie Wasserman Schultz (D-Fla.) the ranking member on the VA subcommittee, said the effort would cost $16 billion over many years, a figure that Shulkin did not dispute. The Cerner contract itself is expected to cost $10 billion, with other associated costs including network modernization and the maintenance of existing products added to the bill.
The committee has yet to sign off on a reprogramming of funds in the 2018 budget to launch the Cerner deal. This is expected to occur with the next funding bill, due March 23.
Additionally, VA is asking for $1.2 billion and a dedicated new budget account for 2019 to work on the Cerner system.
Shulkin also addressed reports of "palace intrigue" at the VA, with advocates of privatized services for veterans pushing both publicly and behind the scenes for his replacement. He said he "deeply regrets" the distraction.
"I've made it clear to everybody in my department that I have no tolerance for anything other than the business that we have to do for VA," Shulkin said. "I believe that we are getting back on track with that."
Press reports have suggested that President Donald Trump is considering replacing Shulkin with Fox commentator Pete Hegseth, who advised Trump on the campaign and heads a conservative veterans group.