Good news on VA Cerner deal

With help from Darius Tahir and Mohana Ravindranath

A TALE OF TWO VAs: On the one hand, some signs of progress on the Cerner contract… but will Shulkin be around to oversee it?

First the good news — VA officials we interviewed for a story last weekare still worried, but Rep. Phil Roe, chairman of the House Veterans’ Affairs Committee, seems pleased with the deal the VA is preparing to cut with Cerner. He told Stars and Stripes that Shulkin had assured him VA providers will have access to at least five years of past medical data without special effort — unlike military users of MHS Genesis, who have to rely on a poky Joint Legacy Viewer to find earlier records.

— Cerner told a HIMSS conference investor presentation that the VA will go live in 48 waves that will begin in the fourth quarter of next year with pilot sites and then run through 2027, while DoD go-lives through 2022 will consist of 23 waves. (H/t to Histalk).

—Shulkin, speaking Friday at HIMSS, asked health care providers to sign a pledge affirming their commitment to openly share data with his agency’s health care providers—11 health care systems have signed up so far. The VA will give developers increased API access to that clinical data so it flows into apps that help veterans, Shulkin said. Giving a diverse set of developers access to VA data can “only enhance our analytical capabilities,” John Windom, the leader of the Cerner contract negotiations, said during another HIMSS session. More here.

— Shulkin told reporters that he’s looking into changing the VA health care system from an opt-in to opt-out system for EHR sharing. Currently about 20 percent of veterans opt in to a system that allows the VA to share their records with providers. Generally very small percentages of patients choose not to share records in opt-out systems.

— Also, Shulkin said the VA and the White House have offered technical advice on drafts of the Senate “Choice 2.0” bill to increase out-of-VA care for veterans, adding that he’s “optimistic” it will gain presidential support. Two versions of the bill, providing varying degrees of veteran choice in private care, are under debate in the Senate Veterans Affairs Committee.

Now the bad news (for Shulkin, anyway) Axios reportedlate Sunday that Trump and his chief of staff, John Kelly, are fed up with Shulkin and seemingly turning toward his adversaries. Trump and Kelly, we’ve also heard, aren’t happy with Shulkin’s public assertions that they gave him the power to oust political appointees he’s at war with. To add insult to injury, Axios says, during a Shulkin visit to his office last week, Trump dialed in Pete Hegseth — the ultraconservative Fox & Friends host who was a candidate for Shulkin’s job. This Washington Post story lays out Shulkin’s tsouris in living color.

CYBERSECURITY WILL COST A BUNDLE TO MANAGE: A Ponemon Institute survey released Monday finds that health care companies’ spending on IT increased from an average of $23 million in 2016 to $30 million annually this year, with a growing percentage of it going to cybsersecurity. While more information executives believe they have good security than they did two years ago, only about half the health care systems that responded to the survey have a chief information security officer, and four of five said it was difficult to recruit skilled personnel. More than a third of respondents said their organizations experienced a ransomware attack in the past year.

— At HIMSS last week, we separately interviewed two cyber experts about the current cyber environment: Merlin International’s chief technology officer, Brian Wells, and CynergisTek CEO Mac McMillan. Two highlights: The percentage of IT spending that goes to cyber has increased from about 5 percent to 8 percent over the past two years, and health care systems with the money are investing in artificial intelligence to outsmart increasingly smart hacking software. Read the Q&A here.

Tweet of the Day: Fo r evidence on how VA CPRS compares, key line from our JAMIA study of ~2500 PCPs tells all: "..only 19% of providers thought that the non-VA EHRs they used were better than VA’s CPRS”

Welcome to Monday morning eHealth, where we recovered from Vegas and HIMSS madness over the weekend by catching this remarkable “ Outsiders and Vanguard” exhibit at the National Gallery. We recommend it to just about anybody. Send tips to [email protected], or via the twitterverse @ravindranize, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

MAGIC JOHNSON’S MANAGEMENT TIPS (for those who missed the bitter end of HIMSS): The former L.A. Laker great left HIMSS attendees with a few tips for success in business during his closing keynote: Hire people who have the same work ethic as you do — “I don’t hire clock watchers, I hire people who stay until they get the job done,” he says — and ensure that each employee fulfills their responsibilities. “If the receptionist breaks down, it’s going to trickle up...everyone must play their role.” No interoperability insights, however.

RESEARCH FINDINGS: A study by UnitedHealth Group and Children’s Hospitals and Clinics of Minnesota showed that children 13 to 17 with Type 1 diabetes got better blood glucose control than a control group during a six-month intensive remote therapy pilot program. The kids and their parents reported better health-related quality of life with regard to diabetes care. Details from the news release here. And the full study here … Work byEHR safety expert Hardeep Singh and colleagues in the Veterans Health Administration found that a national quality improvement program could reduce unintended safety problems and clinical slowdowns associated with distracting clinical alarms. The study was a response to surveys showing 70 percent of VA clinicians cite excessive EHR-based “inbox” notifications. The authors recorded notifications at all 148 facilities operated by the VA, restricted the types of notifications and trained primary care providers to process them more effectively.

PEOPLE: CMS has appointed James Bailey as ombudsman for Medicare pharmaceutical and technological oversight. The position, required by the 21st Century Cures Act, responds to concerns from manufacturers and others on Medicare coverage and coding for pharmaceuticals and other technologies. The ombudsman can provide feedback on new codes or coverage for technologies … Survivor producer Mark Burnett won’t be a member of S board upon expiration of his term, per an SEC filing.

HACKING OPIOIDS: New York Attorney General Eric Schneiderman’s office on Sunday hosted a hackathon on the opioid crisis. The exercise was focused on encouraging New Yorkers to bring their unused prescription drugs to designated drop boxes across New York State during National Prescription Drug Take Back Day.

WHAT WE’RE CLICKING:

— Modern Healthcare: CMS punts on joint replacement bundle question

— Health Affairs: Two-part article on the futureof public and private health care for veterans

— Modern Healthcare: Drive to consumerism in health care visible at HIMSS

— Healthcare IT News: How NASA’s telemedicine doctors keep their astronauts healthy in space