The new Cerner electronic health records replacement for VA’s VistA system will cost 60 percent more after less than one year of implementation, estimated at $16.1 billion.

The original cost estimate for the EHR solution was $10 billion. The agency went back and forth over the Cerner deal, which was inked by Secretary Wilkie before he was confirmed as the replacement for David Shulkin, MD.

Cerner received a no-bid contract for the deal after securing the same for the Department of Defense. Neither contract deal has proceeded as planned with the current cost increases coming out one year after the deal was inked.

The deal received much pushback one year ago when numerous authorities in the field projected the EHR transition has less than a 10 percent chance of succeeding.

One factor raised is the size of the Cerner system and its broadband requirements when communicating inside and outside each facility.

Another issue recently addressed is that the current Cerner EHR system is designed for insurance billing purposes. This means the new system may not adequately address the needs of federal agencies that do not bill insurance companies.

“VA is different. The focus of the VA’s electronic medical record is never about clinical documentation to support billing. It’s about giving the information to the provider at the right time to inform the best care. There are true risks to patients if they don’t do this right,” Heather Woodward-Hagg, PhD, former National Program Director (Acting), Veterans Engineering Resource Centers (VERC) and Founding Director, Veterans Affairs Center for Applied System Engineering (VA-CASE), told ProPublica.

Word is the transition, if it works, will cost tens of billions due to the size and complexity of not only the software but also the hardware required for such a behemoth to operate effectively.

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47 Comments

  1. Typical VA Modus Operandi. Spend hugemongous taxpayer dollars on pie in the sky ‘systems solutions’ that never deliver what they promise nor are implemented on time and at/under budget.

    60 percent more? Optimistic foolhardiness at best. Wait one more year, then revisit those figures. By the end of the third year – – – you will be into 125 to 150 percent more territory.

    Luckily for them, VA does not have to show a profit to remain in business. Otherwise, they would have shut down decades ago.

    And their ‘Customer Service’ is the dictionary definition of World Class Suckism . . .

    C – L – U – S – T – E – R – F – U – C – K

    • Jim, fully agree. No negatives directed at you in this rant. Just getting it out. And they should take your advice about unions. If we can’t get support, health care, respect, or laws supported and protected under the Constitution, Bill of Rights to HIPPA violations or basic rights then we or the masters should not have to bow or follow AFGE unions/affiliated/contractors or the like and their contracts or demands. What is good for the goose should be good for the gander. No laws or support for us… none for them either, nor for the SES types.

      I wonder if this is like the lying “Hagg” VA, CBOC IT specialist informing me not to dare question a highly educated and VA trained “woman.” Sounded more like an activist to me than a VA employee in place to give aid. So is “Hagg” in place to also pacify the “Women’s March” movement demanding all males be replaced by them and men must bow to and never ever question? Just pondering due to experiences.

      One of the over forty from Indiana pulled into government service and work under this admin and before? Reckon so. And the “Hagg” is just another one boasting of superior “leadership” skills and such. Same stuff over and over again regardless of agency or position… they are all specialist, experts, all knowing, perfection, better than us. Yeah, like I am inclined to believe or follow someone just because of a mainstream diploma from a nation of activist lying colleges, self-serving “professionals? Not me. Oops, not PC is it? Can’t tell all those Haggs or Hags apart.

      Not about billing, insurance, etc? First thing even with a “Choice Card” was about back-up insurance, “did the VA send you,” such as having “any Medicare or Medicaid… or will this be cash, debit, or charge.” It’s all about who is going to pay before services are rendered or must pay before leaving the facility, immediately. Oh and plus any “new patient fees.” (?) Oh and after leaving the VA I was lost in the Medicare system and twice during visits to a civy hospital. Just like being lost in the VA and a few clinics with all their expertise and Phds or affirmative action types. And over a couple years and still can’t obtain copies of my files from a local major hospital and other rulers we were threatened with at the VA. And others won’t accept me until they too get some files from them after leaving the VA? How nice. They can always “network” and function well enough to see to it we are ignored, attacked, given false information etc., by the various establishments of the fascist and money junkies.

      Contact our fearless representatives, lying congress people, VSO, outreach jokers, media or any other agency supposedly to help us? Good luck with that. Guess people aren’t reading past Congress members like Sen or Congressman Black about how corrupt the “Districts of Columbia” is and all about. And who all they serve and it ain’t us.

      Whatever happened to that instant emergency medical records planning supposedly covering every crevice in American health care? Available to EMTs instantly while attending us and forwarded for preps to a emergency room? Big phony failures, big money made for some corporation/affiliates, and failed security.

      Odd isn’t it if algorithms, high tech and such/assessments/IT can work well for malevolence, nefarious purposes, propaganda, social engineering, *censoring, banning, but anything that MAY be a little good are complete failures yet the money is already banked.

      Random quote from “American Policy Center”:
      “Specifically, HUD announced that it is withdrawing use of a computer assessment tool that maps every single neighborhood to gauge if the community is in compliance with “fair housing” grant rules.

      This “tool,” enforced by HUD, has made every community which applies for its grants to complete an “Assessment of Fair Housing,” using its computer program – or “assessment tool” to identify all “contributing factors” to housing discrimination.

      The information to be gathered includes a complete breakdown of race, income levels, religion, and national origin of every single person living in the community.

      HUD then uses this information to determine if the neighborhood meets a preset “balance,” determined by HUD.” Unquote

      Think that is all that they have been or are doing?

      • “Whatever happened to that instant emergency medical records planning supposedly covering every crevice in American health care?”

        The only crevice the ‘great plan’ covered was the arses of those who practice avoidance of accountability while working in various medical fields. Certainly the plan did not cover veterans who have honorably served their nation in foreign wars.

        Truth is the government got what they wanted out of us, and are all too happy to throw us on the scrap heap. And the citizenry of this once noble country are either all for it, or too damn clueless to know what is happening.

        Either way, their can be zero doubt that this country, and our fellow citizens have left a shitload of broken promises to its combat veterans behind it long enough to fertilize the Sinai Desert.

    • Agreed. Is there no ability to hold Cerners feet to the fire under the terms and conditions agreed to previously? Who were the negotiations conducted by on the VA side? Tell Cerner do it according to plan or be booted. They can’t afford from a stock price to be jettisoned, so they will ask to renegotiate; at which time I will volunteer to be part of the deal team for the VA. The VA clearly needs experienced negotiators.

    • Beyond cost “over-runs”, you can darn bet that there won’t be any significant liquidated damage requirements in the agreements if they are late, or it doesn’t perform. You can bet that the VA contracting office let those normal commercial terms be included. If they are, the full Statement Of Works will be so sloppy that a good lawyer could not recover any damages for functional failures… and cost over-runs. This is how your government rolls. Gets me all flag wavy n’shit.

  2. Makes me think of the first Led Zeppelin album. This will be the demise of the VA. I see those 3 monkeys again sitting in DC trying to splain this one. We just might get our wish this time. I see the snake eating it’s tail.

    • I’m constantly astonished that this particular led zeppelin remains afloat decade after decade. Must be all the dead vets they keep jettisoning…

  3. Hello Veterans such as I jam the email your Senators or Representative contract the Veteran Affairs Committee passed your belief how to improve Veterans Health Care and Spread to your Friends they don’t have to be Veteran to jam their email to their Senators or Representative contract the Veteran Affairs Committee their belief how to improve Veterans Health Care.

  4. I’d like to see these BS masters from the VA and their Cronies, get slammed by Rep. Trey Gowdy
    Once and for all!!

  5. Those funds should be used to assist Veterans in recouping from their injuries, and to fund additional medical clinics for the prevention of suicide’s that continue to plague our Veteran communities

  6. Given the snails pace of this project…
    Is this a system quote for W2K and almost 3G capable?
    Will it be fully operational before 6G hits its stride?

    • @Rosie – – – Scuttlebutt has it that it is for W2K with the applied security patches, and has coding to negate the Y2K problem. 3G is to be supported in the next service release. This will require the purchase of just a few minor items such as routers, etc.

      One upside to the new system is that with minor coding changes it will compute ’employee bonuses’ in record time, thus ensuring that VA CARES !!!!

    • @T,
      I wonder where that ‘smart connect’ FR to ER technology proposal stands at this point.
      Did you hear about A____n getting a paltry 129M tax refund this year? Uncle connects.

      @Jim,
      Man, I was tongue-in-cheek’n that statement!

      • @Jim,
        My mistake… that’s A____n CORPORATE tax refund on over 11Billion TAXABLE income! Do I smell a boycott on the horizon?

        Katie Porter “https://porter.house.gov/about” is another one I am keeping a close eye on. Very wise on banking matters, in fact it was quite a thrill when she asked in a hearing the other day, “…the difference between interest and APR…” then, she drew out a book on the subject to correct the response given and read from the very book that she herself authored for educational purposes. YT has other coverage of her no nonsense approach.

      • Rosie, that smart instant connect stuff failed years back after talking heads on TV reported it was coming, then working well, then crickets. A retired EMT said it never began in the first place and was pie in the sky tech. That was also about the times I was getting lost in various systems to always hearing about systems changes in hospitals to MD’s offices and all about systems or pc “glitches” or being “down.”

        The CERNER site is also a fairly good, typical corporate styled marketing read. The “Podcast” are curious too. They can do it all for a vet from the VA to the outside so that has to deal with billing, credit scores, dealing with “the most powerful women in health care IT” whatever the hell that is supposed to mean. Guess that is part or reasoning why so many at the VA and other’s IT systems can be so cocky and feel above the rest of us. Oh, and it’s not just the female side of the gender issues.

        Like others using the ‘no-contract bidding’ should be of concern too just like all the nepotism or affiliated groups issues. Just as bad as those supposedly sealed contract schemes where the same ones in the sand-box are constantly used with those “secret bids’ not being that secret in the political or business world. I got some bridges for sale if people want to believe any of that Kool-Aid.

        They can do it all. Get revenue, take care of board members and stockholders, staff safety, low burn-out rates, global, patient safety, blah blah. In a ever changing and merging of systems and up-grades. Not much about real concerns or issues like PCPs or MDs not allowed to do in clinics or hospitals that they were trained to do but has to play the spread around game. Nothing about keeping politics or activism (“most powerful women”) out of health care or the VA. Nothing about any hospital staff, health care workers being held accountable or trained for patient confidentiality, leaks, gossip. They make it all look warm, fuzzy, perfect.

    • @Rosie,

      Cerner is not really into the hardware element, beyond specifying the requirements for its software. The basic Cerner Systems is an Oracle-based RDBMS, so it will evolve as Oracle evolves. The client-side applications are more technology-dependent, but given VA’s hardware budget, that should not be an issue.

      The VA’s existing network and infrastructure are certainly not “state of the art”, but they really couldn’t be—the VA is too big for that kind of rollout to ever keep direct pace with “the latest”; but it doesn’t NEED to be, either. As long as it can be “current” to within two modern-day generations (saying, for example, there have been four generations of smartphones, so their tech could work with an iPhone two iterations back—one that no longer gets updates in the iOS). Once they can actually get **current**, then catching up to one-generation behind the curve is much easier.

      Typically, in government acquisitions, the Perfect is the enemy of the Solid. While pursuing the Perfect is appropriate as an undertaking, the near-term goal has to be something that gets off the ground.

      My nickel.

  7. @Rosie – – – I know. But Bezos be the HMFIC of Amazon, so . . .

    WRT Katie Porter, I watched with glee “live” as she embarrassed Tim Sloan (CEO Wells Fargo Bank) regarding his ignorance of APR. She also caused Jamie Dimon (CEO J P Morgan) some discomfort regarding problem solving regarding employee salaries.

    “https://www.youtube.com/watch?reload=9&v=cBZSnD98L0U”

    I like her a lot. We need a whole lot more like her in government. And AOC as well. If America can be saved, these are the people that will be having to do the brunt of the work to get it done. Not folks like Mitch McConnell or Nancy Pelosi.

    • AOC. Are you fucking kidding me. Your joshing me right? GET THE FUCK OFF THIS WEBSITE!!!—NOW!—YOU DO NOT BELONG HERE! YOUR ASS BELONGS TO YOUTUBE! STAY OVER THERE & POST YOUR PICS & SAY HOW WONDERFUL YOUR PATHETIC LIFE IS. WE DON’T NEED THAT SHIT HERE!

    • Jim,
      I hate to burst your bubble on Cortez. Only a few days ago, at her town hall, she stated, quote: “all Americans should use VHA!” AND “veterans should NOT be allowed to use outside healthcare!”
      There’s one big problem here with her proposal. Congress uses special outside healthcare! They’re not like us.
      On the “Choice Program”, she wants to completely eliminate it! What about the monies set aside for it? Where will it end up?

      • Not bursting any bubbles at all, Elf. Haven’t seen/heard that one yet. Been busy. Is it on YT, and what date was the town hall held? Need some search parameters. This I must see for myself.

      • Hey Elf,

        Just finished reading 7 articles on her town hall WRT Veterans Healthcare. Holy Dog Crap, Batman!

        She really is so naive and WRONG on this particular issue.

        Thanks for cueing me in.

      • Actually, Jim, you should probably watch the thing. Agree or disagree with Ocasio-Cortez, she is never naive or clueless. She may say a lot of things people who maintain the status quo don’t like—which they immediately decry as naive—and one can disagree with her goals, but she is smart and focused and not distracted by the shiny objects lobbyists use to keep their fiefdoms in place.

        Her objection to Choice, for example, is sound, based on fact, and quite grounded: what is the point of the nation’s second-largest department, if it cannot provide one of its two primary functions? Spending money to send Veterans to health care providers outside of the VA is a poor long-term answer to the problem of scheduling and specialty-care availability. Instead of drawing their pay and controlling their budget, while not performing their core responsibilities, VA Administrators should be held to account by the Administration (of Party D or Party R, either one) for issues brought to light by the Congress in their oversight role. But they never are.

        That’s something I completely agree with. The problem with having an IG reporting to Congress is that Congress cannot fire anyone in the VA. Only the Administration can do that. So when the same “scandalous” behaviour surfaces again and again and again at the VA, and NOTHING is done about it—and no one is held accountable in the way we would be—that is on the Administration (of Party D or Party R, no difference there).

        Ocasio-Cortez is a firebrand. She is an actual Radical. Many of her solutions completely change the way things are done—including VA Health Care. That’s generally too much for me. But for all those who call for dismantling the VA, that’s exactly what they are looking for—tear down the old edifice, and don’t even both to replace it—go a different direction (say, Medicare For All). I think its crazy, but it definitely gets rid of the VA.

  8. What did the Lint say to the dryer?

    When I grow up I’m going to be a dryer fire! hahahahaha.

    Jokes! Everybody’s got jokes!

      • Fake name much lately tuff guy?

        Agent Provocateur lately? What’s a matter tough day at the SSA, or VA trying to provoke Honorable veterans?

  9. I actually worked on a Cerner implementation as my next-but-last consulting job (I was an IT consultant). Cerner was going in at Federally-funded Regional Medical Centers, and I was at one of the “pilot” sites.

    Cerner IS a huge system. They have very sophisticated infrastructure requirements beyond simply inter- and intra-net bandwidth. The problems with Cerner at many of the big hospital-clinic networks (a main hospital with directly-managed clinics throughout the region) were almost exclusively with poor management decsion-making on the “customer” (hospital) side.

    Cerner is a private, for-profit corporation. They are not donating their product, they are selling it. Their contracts, just like those of EDS or IBM, spell things out exactly. The people who negotiate the purchase contract for these systems are, with no exceptions I’ve ever noted, in no way qualified to do so. And because they are The Big Boss, they are easily flattered and coddled by a Cerner Sales staff eager to close an extremely lucrative deal. The customer-side management usually has no idea what the technical requirements are, or terms mean, nor what is involved in implementation.

    Thus, one winds up with a software package that runs on a big, powerful (usually pair of) server that may not be within the expertise of the IT/MIS Department, or may be incompatible with much of the infrastructure (network topology, IT systems structure decisions that require major hurdles to back off from, and etc…) in place in the data centre. Cerner’s contract makes it clear that they are not responsible for ANY of this work. The client/customer is supposed to have or acquire the expertise to make their side of implementation happen—everything that connects the Cerner server to their IT World.

    The guy the sales person took to the hockey game, and out for drinks, and to the swank resturant, etc…, may have once been an IT guy (maybe), but their expertise is long-disused. More often, in this sector, they got promoted out of operations because they were not very good to begin with. So even if they can run a pretty good day-to-day IT/IS organisation, they do not have the experience or expertise to understand what all the implementation decisions mean in terms of work, disruption to the hospital-clinics, and costs.

    At the site I worked, the problems did not really belong to the Cerner people. The person who bought the system had “resigned” after being caught having sex with the DBA Manager, who was subsequently promoted to be the IT Manager, and worked under a temporary IT Director (because the Director was “rsigned” for letting the sex happen **at work** despite knowing all about it). The temporary Director had no buy-in and the permanent IT Manager’s qualifications were non-existent; any time the Manager’s technical knowledge was called into question it was interpreted as a threat. The IT Manager’s focus was on people who would not challenge their authority or “make them look bad”—all but completely inexperienced people who felt lucky to have the job, or has-beens who were so out-of-their depth as to be useless.

    Cerner is a records system. It IS completely focused on getting the records to the provider first and foremost. It does include a sophisticated and complicated billing interface—that’s an industry standard for making the stuff that pays the bills in our way of life. But in no way does the existence of the billing interface compromise the delivery of health records to workstations (providers).

    In its simple profile, Cerner is a big Relational Data Base Management System. Like many RDBMS sold to perform formerly-labour-intensive workloads (like Personnel Management), it has a steep learning curve. But the VA already uses an RDBMS, albeit a poor one, so the learning curve is vastly simplified for everyone but the IT people.

    The IT infrastructure and IS discipline of the VA is nowhere near ready for the kind of loads and demands a system like Cerner (even the one I worked on twenty-odd years ago) would put on it. Every clinic would have to have new workstations and network infrastructure (for the first time in fifteen years here—they moved the old IT to the brand new building at AOPC). And the system requirements are serious and heavy-duty.

    It’s likely the VA is like any other commercial entity—with rare exceptions, to be sure—where the big boss wants to have the very best equipment and be able to do everything, even though they never will, and really only need to read their email and browse the internet. So a lot of money and effort goes to getting Big Bosses happy, and THEN the nightmare starts; real implementation.

    Also…I observed as a Consultant that IT management tends to be resentful of outside help, even when it’s clear they are out of their depth—it’s as though they resent knowing they were hired to do their everyday job, and not be an expert on one-time (even if it is a three-year “one-time”) job. So its likely every VA clinic and hospital and Region and administrative unit sees itself as entitled to special treatment, resentful of centralisation, and unwilling to move the project forward out of parochial interest.

    All of that has to factor into a project like Cerner. And it is foolish to expect a Cerner salesperson to make the job seem like the nightmare it will be—the “other guys” (like SAP variants) will gladly claim their’s is “turn-key” (nothing is ever “turn-key” in reality). They are not responsible for the organisations well-being—that is the job of the ego-driven asshats that are in charge, and they are not going to appear weak by asking for advice from the people who know, especially if that advice is “it will cost another 2/3rds the purchase price for us to make it work in our house” (which is not actually unreasonable, it’s just a big number that scares people who were selling the project based on the cost of the software and server).

    Peace out.

  10. Cerner was part of the EHRVA (Electronics Health Records Vendor ASSociation. Sponsored by HIMSS.org a non-profit 501C fraudulent tax haven. Cerner competed among many vendors for this golden ticket- it goes back to before the days of DR Brailer (MD Brailer, a Buddy Hacket look-alike) . THE SCHEMING for the GOLDEN TICKET has been around for years. The truth here: lots of Vendor insiders bought stock in these companies on the cheap, some of them even ran IPO’s. Back when the VA used VISTA a program written in MUMPS the vendors were trying to snake the lions-share. In 2005 a micro-version ( small office) VA VISTA system was available to download for small private physicians offices- the EHRVA and its money grabbing others jaw-boned the the VA to stop the downloads as the adoption of this small office VISTA system meant no money grab for the Vendors under the tent. By certain expertise in this area I know that Cerner conducted and sponsored military trials , even inviting military people to attend the HIMSS Annual Conferences ( sessions closed to the public but only Vendors allowed under the tents). Does anyone here think that great fortunes have not been made on this deal? Inside and outside the military lots of people have gotten filthy rich on this deal. George Bush JR signed into law (Aopr 26, 2004) the EHR Act REQUIRING physicians to install EHR systems. YUP, this was and is an old fashion money grab. Gee, how woul i know this? Could I have been Former Patient Safety Officer, HIMSS.org, MBA, BSIT, BSN, BA, Network Engineer that blew the whistle on this? That hasn’t stopped them from proceeding. If Good Old Boy Chuck Grassley knew about it in 2008 , and he did because i sent him a love letter, and the DOD as late as 2018 said that Cerner failed so many times in Field Deployment Trials– well we don’t have to have an IQ of 130 like this expert to figure out this is about the bucks and not about the Veterans , Healthcare or even active duty people. This is all about ZEE almighty DOLLAHS & Drooling Rats. This EHR stuff doesn’t work right , it interferes with good clinical care and requires the Doctor to keep his eyes on the computer , not the patient. This shit does not belong in the exam rooms, plain and simple. Ohj yeah , and Doctor VAMC-Schmuck-Douchebag doesn’t know any better either . At your next VAMC visit , ask him if he has any clinical decision support tools and look at his face for shades of Buddy Hackett coming through.

    • CDST, I’ll ask them. It’s easier to increase stock value through some form of manipulation, than it is to increase profits, especially for a company like cerner that’s failed so many times. Cerner stock up, again

    • Expert. That all is about correct. My last two PCPs at the VA couldn’t do much more than try to find something or tests on their systems and one didn’t look me in the eye once. Then telling me she didn’t have time to go over my records, or find test or associated clinics and had to forget years of care and go back to day one and do ‘everything’ all over again. Then passed on to another clown and activist. But I am the bad person here.

      Got a question for the expert or the well trained here. What about that automatic deleting of test results and emails from a outside source or contractor? Or about the secretive email programs used between health care workers or MDs that only those with the code words and specific programs can use?

      Oh and Happy Easter to all, whatever happy is.

      I would also like to know who the stock holders are, board members are, and any secret investors which there probably are. Federal workers, SES types or Congress critters? Can the DoD and others use CERNER to find all that lost trillions of dollars, audit themselves or other thieves in government, or stop any VA retaliation and civilian associates too?

      Big lies and propaganda I deal with.
      “https://www.myunionhealth.org/about-us/mission-and-vision”

      Page Not Found. Used to be a list of contact info for supervisors, dept heads, CEO, etc. Not now. We aren’t supposed to know their names or positions. For their security and safety in part due to us crazy vets and possible stalkers they fear so much.
      “https://www.myunionhealth.org/unionhospital/administration”

      Went to this:
      “https://www.myunionhealth.org/patients-and-visitors/phone-directory”
      Just a list of numbers and activist/deflecting/defensive secretaries to deal with all playing their games and covering VA butts and that of many others. Don’t dare ask about IT failures, about my records, or getting in contact with department heads and supervisors. Big no-no. Gotta go up on their turf and risk set-ups, false accusations and arrest for being on their property just for trying to get my records and find out why all the hate and retaliation VA styles and continuance. Oh I’m a hater, complainer and there are those we “are not supposed to challenge or report about mis-conduct or malpractice and …. more. And to never report to medical boards, state agencies, poly-tick-tions, or their buddies at the state AGs office who claim the VA is perfect and refuses to investigate matters.

      So now people like me can’t get the names of staff or those playing games and the IT crap with files. Last time I called up a super told me come up and sign another (3 now) release forms and she’d get them. Not so. Went up, staff in the clinic had the name tags turned around, big smiles, and no records and no copy of the request given either. Same treatment at the IT and records office. Is that “networking?”

      Ahh it all comes together now and why all the defense and attacks, black-listing and black-balling:
      “http://www.insideindianabusiness.com/story/29819022/union-hospital-appoints-new-ceo”

      Tons of BS and IT games going on and have. CERNER and many others will remain immune from any prosecution or blame… too? Now zero transparency from bottom to top and all around but plenty of passing the buck and covering-up happening. Plenty of activism and corruption full circle while we pay the price of bad health and total neglect or the attacks. And for the past few years we aren’t allowed to even know the names of those playing with our records or works at any IT station???!!! No dot connecting? Plus the no recording signs flying up in hospitals, court houses, LEO stations, all the censoring, no questions allowed, etc. What fun. I’ll get this up before some of it is scrubbed from the net too.

      • More info request I forgot this happy day of chocolate bunnies.

        I was wanting to mention things I’m told I am dealing with like the “dark net,” or those hackers with this TOR business or some from what ever it was ‘dot orange’ or dot something like that. On top of the usual FB and other forms of censoring or “re-directing” from original sites like Ben’s here now and then, plus more odd issues.

        And of the use of non-HIPPA/HIGHTECH compliant, insecure, medical centers use and problems of changing from like, back when, to recently, Win 8, then issues of and stopping Win 7 more recently or ending by 2020. Then on to the many excuses given and issues with Win 10 and laws forcing new technology or upgrades in hospitals, ready medi colleges for activist, or MD offices supposedly. Going to Win 10 and it malfunctioning or not fitting in, programs not functioning, I guess were some of the issues my fly-by-night health care offices were dealing with. My house mouse in one office says there is no way or it’s not easy to stop the out-side data collecting or abuses on any of this stuff CERNER included. Maybe some of you techies can make sense of all this stuff. Or about the “CERNER MILLENIAL” (whatever the hell that is supposed to be a picture of perfection of) failures of the past and will the house mice spoke of.

        The forcing people to WIN 10 for a while now and flaring up more-so today over all this will be interesting to see what happens in high tech perfection land. Churches to musicians and others seem to be squawking over this as well. Health care..crickets for the most part.

  11. Should outsource to China, the can use technology stolen to adapt to. Plus can borrow some 30-40k people from the Nike Jordan factory and wrap this up in a couple days. If falling behind can send Kathie Lee Gifford to choke the crap out of them, dropping the minimum age to work to 4 years old. It is business and easy to manipulate. All this money which will always be wasted because the lazy idiots typing with 2 fingers with their tongue out touching there ear lobes. Can’t wait to die because my life is a nightmare

  12. Congress pushed this on the VA. DOD chose Cerner. Saint Louis is Cerner’s corporate office. Saint Louis also has some DISA data centers, which hosts some VA servers (co-located inside DISA facilities). I think DOD is driving the bus. DOD is doing most of this. MilHealth. I think there are aspects of Tri-care and paying for stuff which gets interspersed. Also the VA can bill third party insurers, and get reimbursement, for those who have third party insurers.

  13. Cerner is going to fail in the VA for several reasons.

    1. Rolling out a totally new system to 300,000 users will fail. Too many users, too many apps, too few trainers.
    2. Timing – even if they do get it “working” at a few sites it’s going to take so long to roll it out to all 155 sites that it will be obsolete by the time the rollout is complete (if ever).
    3. Cerner is going to cost 10x what it would cost to improve/maintain Vista. Sooner or later Congress will hopefully realize this.
    4. It’s much better (from a user perspective, and a software engineering perspective) to roll out incremental changes to an existing system like Vista, than to roll out a totally new system to a user base the size of the VA.

    btw, Hardhats has started censoring some people’s comments on this project, like mine.

  14. Hardhats censoring? If that is truly the case, we need to shut them down. The Cerner contract was/is a bad idea. Having lived through several tries at the same attempt, on much smaller scales, I sense this will fail as well, we don’t learn from our mistakes. I guess I will try posting a negative towards this endeavor comment on Hardhats and see if I suffer the same.

  15. Reminds me of a recent misadventure. Last Tuesday I had the opportunity to fly the latest version of an Air Forces’ MQ-5 Predator drone of which was weaponized. No mention of which Air Force is listed here. For all you drone enthusiasts, you may recall that on the GPS control module there is an emergency abort selector command: “Return to Home”. Simultaneously in the background a pilot was listening to a rant by both Pelosi, Schumer & AOC. I became so distracted (disgusted) hearing about the IT waste of time and money – my left thumb accidently dropped down on the controller and pressed “Disarm and Return to Home”. The fucking thing flew all the way back to China!

  16. Arguably, the system isn’t about saving the VA Money. The system is to integrate the Military Health EHR and the VA system. If the VA system could be adopted by DOD, then it might work, but the DOD Military Health System is not inclined to go with the VA system, I guess. Congress is driving the effort. At least that is the impression that I got from what I’ve seen of coverage. Of course parties have changed in the house. Senate remains, so likely agreement may be difficult.

    • A valid point. From my perspective, the problem isn’t with the expenditure, it is with the abysmal management of the project, from poor requirements writing to poor purchasing management and lousy program office management.

      Cerner does work. So do other systems. The problem is not so much in whether one chooses SAP or Cerner or whatever, as in how eyes-wide one approaches the undertaking. To me the VA—and it appears DoD as well—did not pick up any of the lessons-learned from previous Cerner installs at Federal or Federally-funded sites.

      Also, I do believe that the pain is worth it; modernising an archaic records management system that can no longer function effectively on modern platforms is a solid move. The fact that VA’s under-funded, under-staffed IT Department, spread out as it is over the entire USA, cannot implement it has more to do with poor program management than with talent or competence at the SysAd and DBA levels.

      Cerner is built for huge, sprawling health care providers. But it does require a highly-trained and motivated IT staff, and it is intimidating to lower-level Clinic and IT management. One site simply refused to turn the thing on for a certification test, because as long as they didn’t pass the milestones, they got to keep Cerner people on-site running the thing. And it is very, very, expensive in money and time. And like any big change, it causes stress and has bugs that need worked out that can only really be discovered by active use.

      • Insanity: doing the same thing over and over again and expecting different results.

        Then how many generations more will it take to … get it right?

        In my scummy town with four (4) major colleges are pushing out IT experts, along with other specialties, with all the certifications by the thousands and there are shortages?

        Do we see the pecking order and big egos that are huge issues too? Along with those getting degrees or placed in power positions just for the sake of nepotism to activist activities/connections. And God forbid we have to face off with someone with bruised egos or catching them red-handed jacking around with our files for whatever reasons. Or dealing with issues of retaliation that goes far beyond some offended person at the VA … with all those connections to help them with their own agendas and job security.

        No bid contracts doesn’t bother people? It should. Or being led around by wealthy youngsters in Congress that can’t even get their history lessons correct but out to change/try to change the world. Talk about some distractions while many don’t realize Medicare and insurance varies from county to county then some want that option for all to become law. Point being there are NO simple fixes for all the many issues out here to deal with. Plus media, professionals across the board to Congress being our greatest enemies doesn’t help matters.

        Lets forget about the big money in calling in experts or the needed repetition for job security. Like those wanting systems failures or things to not function well. For us low life blue collar workers that took stands against the wealthy and unions/associations wanting to be permanent fixtures in a work place for $$ it’s called throwing the monkey wrench into the machine or gears.

        Meanwhile back at the oasis the Arabs are eating their dates. Wrong story. Vets are suffering and dying by untold numbers as those ‘at the top’ play IT and musical chair games. Civilian care has become another joke and pricey. Or are overly busy supporting corruption and covering their asses regardless of human lives. And those in the biz or educated not giving a damn and at times shown we old people/vets should just die off and go away. The majority are forgetting about the suicides and real life suffering going on out here… off the keyboards, while bugs are worked out, never really. And I haven’t seen much stress past the question dodging, smiles, or the many excuses. Especially today since questions or filing any complaints are deemed totally un-acceptable then all hell breaks loose. Like smacking a Hornet’s nest naked.

        Never seen the use of KIOSKs work for me either after years of “active use.”

        Does Micro-suck, the DoD, DHS, CERNER, VA, others/corporate minded, ruling medical colleges etc., care? Nope.

      • @T

        As usual, I already wrote about everything you brought up that was actually topical—I have no idea what Arabs eating dates has to do with Cerner and VA records, or why it’s OK for you to use your keyboard to type, but if anyone else does they are killing veterans.

        I did not explicitly use the phrase “no-bid contract” when writing about graft, greed, and sexual extortion. But I did cover every topic you posed in your “Reply”, except the Kiosk thing (which I will).

        When I wrote about poor management and the influence wielded by higher-level managers (Directors, Vice-Presidents…whatever they call themselves), I was addressing both acquisition—what gets bought—and implementation; being a Systems Consultant, I saw more of it from the implementation side, so I felt more comfortable speaking to that.

        Honestly, T, I feel as though you either didn’t read my post, or what you are unhappy about is that I didn’t use all the politically-correct language to blame the people you blame.

        One—of several—of our fundamental differences is that I don’t see the thing as being based on Party D or Party R. I see it being permitted by the venality of both Party D and Party R, and by the apathy of We The People (another point of difference). So, aside from my disinclination to use Politically Correct language, I just don’t see the facts coming together the same way you do.

        That doesn’t mean I am “against” you. I actually agree with you about the reading of facts; we just are far apart on our conclusions regarding what those facts mean, and therefore, how to address them.

        About Kiosks: I am assuming—with all of its risks—that you mean the ones at the VA for checking in. If you mean the ones for doing banking or ordering food, I’m out—I can’t use them either.

        I use the Kiosk all the time. I use a Kiosk to check in to my PTSD therapy, and for my Primary Care visits, and Neurology, and Pulmonology. When they were first installed, they blew (in the bad way). Then the bugs got worked out, and they were cool—I didn’t have to talk to the Admin and hear “thank you for your service” for the fourtieth time that day; they were tired of saying it, and I was tired of hearing it.

        Now I can walk around the Austin OPC and almost half of the Kiosks are OOC. Some are broken, some have been used for parts, but none are shiny and new. I can even log in to the newst software revision Kiosks if I forgot my VA ID—it takes longer, but it’s not that hard to do, even for a Vet with a Cognitive Disorder like me.

        To me, the Kiosk was a positive step. But that doesn’t mean I don’t see how it can be an obstacle to care—for the same reason I like it, you might hate it; you might prefer to talk to an actual person (though I’m guessing you’re no fan of the robotic “thank you for your service” bs either). But the AOPC has both. You can wait for a clerk, or wait for the kiosk. Where’s the actual problem?

      • Steven. Sweet Jesus man. Okay fine we see your ‘implementation’ side of things and how you can’t see or interpret levity or jokes. I read your post (more than once or twice) and try to interpret them from YOUR angle, experience or profession, YOUR individual insights. Imply that I am PC and expect it which is far from me??? New here are ya? Or missing my intentional points about the keyboard MDs or IT whatevers not giving a damn about human beings and suffering outside of their friggin cubicles, affiliates, BFFs, unions or team mates. Rather being about job or position security, all the nepotism, and being part of the big problem with the VA or civy health care monsters that can get by with with file or info manipulations, deletions, withholding, to, or omitting things. Or intentionally jacking around with our prescriptions, to screwing around with us with several clinics about referrals made or refused after years of use or records… being lost. “Oh sorry bout that sir.”

        KIOSKs (yes the VA kind) was merely another side issue of serious malfunctions within the systems. Might be fine in your area but not for all. Waiting in long lines for a clerk may not be an easy way out either or try to connect with one that can’t do their jobs and clueless. We are NOT all alike, VAs are not all alike, we individuals are NOT all alike as so many thing we are and expected to be just like them or experience life just like them.

        I think I’ve shown the extent such IT people and many other staffers go to attack those like me. Changing web pages, dropping information and names of admin out of public domain, how to contact them, or supervisors, etc. How many “keyboard commandos” does it take to ruin people, the whistle-blowers, or those trying to expose the vast amounts of corruption to covering-up various issues or incidents? Answer.. unknown but countless, myriads, vast, when it can run state wide and mess with peoples lives in every which way imaginable and to prevent proper medical care to not having a voice with “representatives.” Or protections from any VSO or attorney out there. But I think we can’t play on the same set of tracks or the same sand-box apparently without more direct specific well worded discussions. Which would more than likely get set off into a spur-line (that is railroad lingo) of mis-understandings, trying to explain our own personal needs or why we can’t easily just “wait” for long periods of time, play games, or use da same language/wording. Besides what we might hate or dis-like or abhor for various reasons of our own.

        Another example. One clinic tried everything out there in rush packed clinic. Sign on the window says “use pc to the left. punch in SS and wait for clerk.” Nothing worked, KIOSK not, VA ID card scanning, SNAFU nothing, a couple of fed up clerks stopped dealing with the long lines and put up signs. As intended but to openly type in our SS # in public for those sitting waiting side to side and behind, all around and near-by to see. The only software or program they could get to work or function enough through the day. No way of covering it up or merely standing in front of it unless I was going to make love to it and hug it but was at arms length away. Was that way for years with promises made of ‘ever-evolving’ IT perfections, merging, VA leaders have the “the fix in” new nation wide programs a-coming, and up-coming changes for the good of all. Yeah, right.

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