Former VA IT exec: 5 ways the VA's $16B Cerner EHR rollout can succeed

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Roger Baker, a former assistant secretary of Veterans Affairs for Information and Technology, shared five insights that can put the VA's Cerner EHR rollout on track for success, according to an Aug. 4 article published by Federal Computer Week.

Mr. Baker recently gave six insights into why the rollout is struggling. Now, he is sharing his recommendations on how the VA can improve its chances for success. 

The recommendations are based on his experiences with challenges launching large programs at the VA, specifically the Veterans Benefits Management System. 

Five recommendations:

1. Accountability in VA's leadership team.

The undersecretary for health must take responsibility for the rollout's success because they have the authority to make decisions that affect care at VA medical facilities. The VA's CIO must play their role as the technology provider of the EHR modernization initiative. For the Veterans Benefit Management System, the team was all working toward the success of the system. The CIO was the rollout partner, and the secretary held them accountable.

The VA is still in the process of finding an undersecretary for health and a CIO, which both require presidential nomination and Senate confirmation. A program that last more than a decade must be able to accommodate temporary leadership.

2. Build with users in mind.

The focus should be on the users when developing, testing and deploying the program. The users should have input into the system, which is imperative for success, he said. The program should demonstrate what it's accomplished every two weeks with critique from real users.

3. Identify how the new system can help clinicians.

The VA should consider why a clinician would want to make the change to Cerner. They should ask themselves how the new system will improve health outcomes and improve their workflow. If the VA can't honestly answer these questions, challenges with the EHR transition are inevitable, he said.

Its current EHR was largely developed directly at the VA hospitals, with clinicians in the loop as software functionality was designed, implemented, tested and refined. The EHR was developed decades ago, but the inputs clinicians gave remain useful. 

4. Don't ignore problems.

Large government programs can fail when leaders suppress known problems. Critical problems must be escalated quickly to ensure decisions are made quickly so the program stays on track. 

5. Keep Congress updated.

Leaders responsible for the Cerner EHR deployment should frequently and openly communicate with Congress about hiccups it encounters. The VA may want to consider over-communicating problems to improve its credibility with congressional staff. All large program rollouts have problems, and congressional staffers have many sources of information about what is happening within the program. The VA should keep Congress involved and informed of the problems it encounters to obtain their support and buy-in during program difficulties. 

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