Issue link: https://beckershealthcare.uberflip.com/i/1161749
45 CIO / HEALTH IT VA has been inaccurately tracking costs of legacy EHR system, report finds By Jackie Drees T he Department of Veterans Affairs is unaware of the accurate mainte- nance cost of its Veterans Health In- formation Systems and Technology Archi- tecture because the department did not follow "well-documented methodology" on cost tracking for decades, according to a July 25 U.S. Government Accountability Office report. VA is currently underway on its $16 billion, 10-year Cerner EHR implementation, and the department needs to provide the EHR ven- dor with detailed information on the legacy VistA system to ensure a successful transition. However, the department has been unable to do so due to gaps in past reporting. "Program officials stated that they have not been able to fully define VistA due to the de- centralization of the development of the sys- tem for more than 30 years," the report states. VA determined the costs for VistA and its related activities at approximately $913.7 million, $664.3 million and $711.1 million in fiscal years 2015, 2016 and 2017, respec- tively. Collectively, the total for VistA during the three-year period is around $2.3 billion, however, of that amount, the VA was only able to show that an estimated $1 billion of the costs were "sufficiently reliable," accord- ing to GAO. Additionally, the department excluded VistA-related costs from the total. "The lack of a sufficiently reliable and com- prehensive total cost for VistA is due in part to not following a well-documented meth- odology that describes how the department determined the costs for the system," the report states. "As a result of incomplete cost data and data that could not be determined to be sufficiently reliable, the department, legislators, and the public do not have a complete understanding of how much it has cost to develop and maintain VistA." The GAO advised VA to develop and imple- ment a method to accurately identify and report the total costs of VistA, which the de- partment agreed to. n Slow adoption of $83M Epic EHR costs Covenant Health millions in losses By Jackie Drees T ewksbury, Mass.-based Covenant Health reported $60.9 million in operating losses after implementing its new $83 million Epic EHR last year, Boston Business Journal reported. The health system has experienced a string of financial losses in recent years, with reported operating losses of $5 million in 2016, $4.2 million in 2017 and $60.9 million in 2018. The losses in 2018 were primarily due to slow adoption of Covenant Health's Epic EHR system, which caused a 30 percent decrease in pro- ductivity at the health system's hospitals and provider practices, Cove- nant Health President and CEO Stephen Grubbs told the publication. Physician turnover at the health system, which has locations in six North- eastern states, also contributed to the financial issues. Earlier in July, the Washington Department of Social and Health Ser- vices reported delays to its $32 million Cerner EHR implementation. Despite spending $21.8 million on the project, DSHS claimed that since hiring Cerner in 2015, no progress has been made on the proj- ect. Mendocino Coast District Hospital in Fort Bragg, Calif., has also ex- perienced slow adoption of its $4 million Meditech EHR system, which the hospital has delayed indefinitely as it negotiates its contract with the EHR vendor over claims that the company provided an only partly fin- ished system. At Covenant Health, Mr. Grubbs said he anticipates the health system will deliver a better financial performance in 2019 now that the new Epic EHR has been in place for several months. n Cerner inks partnership with Amazon Web Services By Jackie Drees C erner named Amazon Web Services its preferred cloud provider in a move that will increase the EHR vendor's analytics and machine learning services to help drive its clinical and business insights. By leveraging Amazon and AWS' artificial intelligence and ML abilities, Cerner aims to enhance clinicians' use of the EHR, lower operational burdens for health systems and improve patient health outcomes. "Our work with Amazon and AWS is a key component for the next chapter at Cerner," Cerner Chairman and CEO Brent Shafer said in a news release. "As we work to transform Cerner, we are joining forces with Amazon and AWS to help fuel our strategy of making Cerner more agile in order to deliver faster, more scalable and secure solutions to clients and patients." Cerner's agreement with AWS highlights the EHR vendor's shi to digital plat- forms, which Mr. Shafer said in January is a way for Cerner to enhance opportu- nities for third-party developers on its EHR. With AWS, Cerner built its HealtheDataLab, which allows researchers to use de-identified patient data to build datasets, models and algorithms that give pro- viders more information on their patients when making health decisions. n