Why is the VA (Veterans Affairs) Switching to CERNER?

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Dusn

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Why is the VA switching the CERNER? They're switching from the best EHR I've ever used (VISTA) to the worse EHR I've ever used (CERNER) and I've heard they're paying 4.4 billion for it. A recent Medscape survey of physicians seems to agree that VISTA is much better, so why are they doing this?
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I use Cerner and EPIC in my practice. Cerner is 1000% better than AHLTA but not as good as EPIC. For folks comparing to AHLTA, you'll be happy (unless the gubmint ****s it up in tailoring it).
 
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To answer the OP: I believe this is being led by Congress. They want a joint VA/DOD medical record. Although there are current work-arounds for access none of them are great. The goal is to essentially have one medical record from the time one joins the military to the time they exit VA care.


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backrow said:
To answer the OP: I believe this is being led by Congress. They want a joint VA/DOD medical record. Although there are current work-arounds for access none of them are great. The goal is to essentially have one medical record from the time one joins the military to the time they exit VA care.


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Click to expand...

Exit VA care?
Will the national cemeteries have access to the record too?
 
Wait a minute, wait a minute...that list is horse****. Where is AHLTA?? Outside the top 400? No way.
 
I believe they were between CERNER and Epic; however, Epic likely refused to let the VA **** their program up with all of the additional applications they likely wanted to add. Epic as a company has like %50+ of the US's EMR -- they definitely don't need to the VA health system to survive.
 
boneboulderer said:
I believe they were between CERNER and Epic; however, Epic likely refused to let the VA **** their program up with all of the additional applications they likely wanted to add. Epic as a company has like %50+ of the US's EMR -- they definitely don't need to the VA health system to survive.
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This is ... dumb.

EMR vendors don't turn down long term multi billion dollar government contracts because they're afraid of customization work or they're emotionally attached to their programs working their way. Epic is individualized and customized for every site they cover. It's what they do. It's one of the reasons it's an excellent EMR.

Cerner's bid was judged to be better. That's all.
 
pgg said:
This is ... dumb.

EMR vendors don't turn down long term multi billion dollar government contracts because they're afraid of customization work or they're emotionally attached to their programs working their way. Epic is individualized and customized for every site they cover. It's what they do. It's one of the reasons it's an excellent EMR.

Cerner's bid was judged to be better. That's all.
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Except Epic is designed quite differently than all other EMRs. Epic doesn't function as a command center that then runs many different applications out of it like for example, Power Chart, does -- nearly all the functionality that you see in Epic is designed/programmed into it. The VA trying to purchase Epic and then implementing dozens upon dozens of VA specific applications that they want to seamlessly integrate with Epic would be nearly impossible, and not something I can imagine they want the headache of performing.

Epic lets you customize which of their features you'd like to run as your health care system's specific EMR, they don't let you purchase it and then say, "Hey, I want you to design these applications for me or program Epic to integrate with our in-house applications that we already use".
 
technically it's "Genesis"-- made by cerner. not sure how it will stack up against the vanilla "cerner" product (I haven't used it) but I think the success/failure of it will depend on how the .mil customizes the suite of offerings and licenses. I'm just glad to have one system that does inpatient/outpatient. of course, AHLTA will live on through a legacy viewer that will keep reminding us of the "good old days." I'm also not sure how things will work for a patient who is cared for in a Genesis system who then moves to an AHLTA site. it may be a painful few years.

I thought epic would be a shoe-in. apparently they misread the market or bid process and should fire their gov consultants.

--your friendly neighborhood one EMR to rule them all caveman
 
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Gastrapathy said:
EPIC is privately held. They know exactly what they want.
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which makes it even more interesting they lost out. I think the decision surprised pretty much everyone. cerner must have had a better shadow campaign... or massaged out the numbers to undercut epic... or had spies in epic's boardroom. the possibilities are endless! lol

--your friendly neighborhood conspiracy theorist caveman
 
Homunculus said:
technically it's "Genesis"-- made by cerner. not sure how it will stack up against the vanilla "cerner" product (I haven't used it) but I think the success/failure of it will depend on how the .mil customizes the suite of offerings and licenses. I'm just glad to have one system that does inpatient/outpatient. of course, AHLTA will live on through a legacy viewer that will keep reminding us of the "good old days." I'm also not sure how things will work for a patient who is cared for in a Genesis system who then moves to an AHLTA site. it may be a painful few years.

I thought epic would be a shoe-in. apparently they misread the market or bid process and should fire their gov consultants.

--your friendly neighborhood one EMR to rule them all caveman
Click to expand...


This is my fear. We can barely run internet explorer on the boxes here. I'm afraid they'll make cerner grind to a hault and be a click-and-wait near the level of AHLTA. My expectations are low so maybe I will be surprised...but based on my experience they take everything that is even remotely good and destroy it (see the recent S3 changes at WR).

On an unrelated rant we can't even keep diet mountain dew stocked in the "galley" (we aren't on a ship for ****'s sake stop calling it that) for more than 2 days. Once it's out there's a 2 week lag until the next shipment comes in. They find even the small things that give you joy/happiness/make you feel better about being at work, and they take it away from you. I don't expect much more from the new EMR roll out.
 
dr zaius said:
On an unrelated rant we can't even keep diet mountain dew stocked in the "galley" (we aren't on a ship for ****'s sake stop calling it that) for more than 2 days.
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The galley sucks (except for black-eyed pea, fried okra, collard green Fridays). Main Street is where it's at. If I found out they got rid of the roast turkey asian wrap with hoisin sauce, I'd go AWOL before I go back to Walter Reed.

As an aside, the squids asking me if such and such clinic was on the "3rd deck" annoyed me infinitely more than them asking me how to get to the
"galley".
 
Ziehl-Neelsen said:
The galley sucks (except for black-eyed pea, fried okra, collard green Fridays). Main Street is where it's at. If I found out they got rid of the roast turkey asian wrap with hoisin sauce, I'd go AWOL before I go back to Walter Reed.

As an aside, the squids asking me if such and such clinic was on the "3rd deck" annoyed me infinitely more than them asking me how to get to the
"galley".
Click to expand...

The gallery just sucked, period. Those two ladies at the center both on Main Street that did stir fry we're the best, if you had the time to wait in line.

Old Reed still had the best regular dining and late night dining facility.

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Was AHLTA ever a decent EMR? I'm interested in hearing from those who were onboard when AHLTA was introduced


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Gastrapathy said:
No, it was worse. Much slower and much less stable.
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Agree! It was actually named CHCS II for a while. I actually didn't mind the inpatient chart that was prior to essentris though. CRS or something like that. It was text heavy but had quite a few shortcut keys that made life easier (unless the monitor you were using didn't show them and you didn't have them memorized yet). It wasn't DOD wide though.


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Gastrapathy said:
No, it was worse. Much slower and much less stable.
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PTSD from those days. having it chug between screens and randomly crash and lose your notes was like playing Russian roulette every clinic. we'd celebrate when it was down because we could go back to paper charts.

--your friendly neighborhood back to thinking happy thoughts caveman
 
j4pac said:
Was AHLTA ever a decent EMR? I'm interested in hearing from those who were onboard when AHLTA was introduced


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Click to expand...

I was at Madigan when AHLTA was being rolled out for the first time. I can remember sitting in the initial training meetings and realizing what a piece of s$#! we were going to be using. I remember a surgical specialist berating one of the AHLTA trainers, and finally the trainer explaining that his company did not invent AHLTA, he was from a company contracted to train us on AHLTA. The company that made it also knew it was garbage and had no interest in being there for the rollout.
 
BlackFrancis33 said:
I was at Madigan when AHLTA was being rolled out for the first time. I can remember sitting in the initial training meetings and realizing what a piece of s$#! we were going to be using. I remember a surgical specialist berating one of the AHLTA trainers, and finally the trainer explaining that his company did not invent AHLTA, he was from a company contracted to train us on AHLTA. The company that made it also knew it was garbage and had no interest in being there for the rollout.
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That's really embarrassing. What a stupid move by the military to contract with a company that wouldn't even have their own people train its users on its rollout.


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Ziehl-Neelsen said:
The galley sucks (except for black-eyed pea, fried okra, collard green Fridays). Main Street is where it's at. If I found out they got rid of the roast turkey asian wrap with hoisin sauce, I'd go AWOL before I go back to Walter Reed.

As an aside, the squids asking me if such and such clinic was on the "3rd deck" annoyed me infinitely more than them asking me how to get to the
"galley".
Click to expand...
 
You guys are nuts. WR has the best galley/dfac of any military hospital I have ever been to and I've been to most. Pizza is on point, carribean bar is amazing, as is the Vietnamese. Salad bar is pretty good. It's also better and cheaper than every DC area hospital including WHC, GT, VHC and Inova. Only suckers who want to pay 15 dollars for lunch go to Main Street.

To the original point, AHLTA sucks. EPIC also sucks but can be fast. Cerner depends on the install, it's okay at WHC. Military will without a doubt screw up the install.
 
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