Brookings Institution: Why the VA's $10B deal with Cerner faces 'long odds'

Jessica Kim Cohen -

The U.S. Department of Veterans Affairs' EHR contract with Cerner is unlikely to succeed in its interoperability and usability goals, according to a Brookings Institution blog post.

VA Secretary David Shulkin, MD, first announced the VA's intention to implement Cerner as its systemwide EHR during a news briefing in June 2017. Since then, Dr. Shulkin has delayed awarding the agency's contract to Cerner, citing various concerns, including interoperability.

In the Brookings Institution blog post, Niram Yaraghi, a nonresident fellow in the Brookings Institution's Center for Technology Innovation, wrote it's unlikely the VA will abandon the deal with Cerner, given the intense publicity surrounding the contract. However, he cited a report from The Standish Group, which found only 6.4 percent of federal IT projects with $10 million or more in labor costs succeeded between 2003 and 2012.

Recent estimates have placed the VA's contract with Cerner in the range of $10 billion.

There are various reasons that federal IT projects fail, according to Mr. Yaraghi. He highlighted a 2006 Defense Acquisition Performance Assessment report describing a concept called the "conspiracy of hope," which refers to the tendency to understate a program's technical readiness, which results in exceeding initial estimates.

The VA's EHR implementation faces additional challenges, he added. Each year, the VA's legacy EHR system — a homegrown platform called VistA — is ranked among the best EHR systems by its physicians.

"[VA] personnel show an immense resistance to change," Mr. Yaraghi wrote. "VA that takes pride in its EHR system and its physicians and nurses have never used another software before."

To access Mr. Yaraghi's blog post, click here.

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