The Senate VA Committee will hold its next EHR oversight hearing this Wednesday.

[Nancy Anthracite]

https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program 

I don't have a link for it yet.  Can someone provide it?

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Nancy Anthracite

[Nancy Anthracite]

I am not having any luck finding out where this will be aired. Can anyone
help?

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Nancy Anthracite

[Nancy Anthracite]

Go to the bottom of the page and click on the link.  It seems to be going to a pending video feed now.

https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program 

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Nancy Anthracite

On Wednesday, March 15, 2023 8:29:10 AM EDT Nancy Anthracite wrote:

> I am not having any luck finding out where this will be aired.  Can anyone

> help?

>

> > https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program

[Nancy Anthracite]

Now I need to find the recording of the meeting. I assume it will show up on
YouTube because it is not at the link below as best I can tell.

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Nancy Anthracite

On Wednesday, March 15, 2023 2:19:31 PM EDT Nancy Anthracite wrote:
> Go to the bottom of the page and click on the link. It seems to be going to
a
> pending video feed now.
>
> https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program
>

[Nancy Anthracite]

Now it IS available at the same link.

https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program 

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Nancy Anthracite

On Wednesday, March 15, 2023 5:29:08 PM EDT Nancy Anthracite wrote:

> Now I need to find the recording of the meeting.  I assume it will show up on

> YouTube because it is not at the link below as best I can tell.

>

> > Go to the bottom of the page and click on the link.  It seems to be going to

[Nancy Anthracite]

PS, it starts at about 25 minutes.

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Nancy Anthracite

On Wednesday, March 15, 2023 5:31:00 PM EDT Nancy Anthracite wrote:
> Now it IS available at the same link.
>
> https://www.veterans.senate.gov/2023/3/examining-the-future-path-of-va-s-electronic-health-record-modernization-program
>

[Steven L]

Very different tone than the House hearing.  

Also hasn't anyone ever defended M as the 'ancient' language?  Epic is based on it still IIRC and large banking units like TD Waterhouse still, right?  

I find it interesting why Congress doesn't dive deeper into the question on the disparity of users VA vs DOD vs Commercial of the cerner product.  Perhaps users of VistA like VistA.   vs prior EHR or DoD and Commercial weren't so good?   Change management certainly is harder when folk change to modern, but less accommodating product-- form vs function priority?

Nice to see Neil Evans in the chair.  Will be interesting to see where he takes this.  He was in our 10x10 AMIA class!

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[Nancy Anthracite]

The DOD folks HATED their EHR. I think anything would be better.

In the commercial sector, they mostly know Cerner and Epic and it is all they
know and it bills well for them. The VA has something to compare it to AND
VistA has far more capabilities, some of which are not those of an EHR. VistA
was designed by users in the VA for patient care to accomplish what they need
so it is no wonder Cerner can't hold a candle to it. The VA should charge
Oracel and Cerner for helping them to make a better EHR!

I was amazed that Mr. McCune would repeat that old saw that M needs to go.
Most who testify don't do that any more because they know it can be shot full
of holes. Surely he has been told that Epic is written in M and many other
systems use it. I am sure he has some sort of twisted justification in his
head for thinking what he is saying is true or he would not testify that way
under oath!

I noticed that Secretary Shulkin began to learned more, his testimony
changed so he would technically not be spreading falsehoods any longer. I
think Mr. McCune at least needs to do the same.

I know that Mr. McCune is frustrated that he cannot hire M developers to meet
his standards, but I think that Robert Baker addressed those issues. But,
nobody heard anything in the press about the testimony of the second panel and
I venture that if it was even heard by anyone in the Senate, it was dismissed
as it did not fit their agenda to continue to use VistA. Repeatedly saying
that Cerner works in the private sector so it is good, does not make it great
or good for the VA.

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Nancy Anthracite

[Nancy Anthracite]

Here is the YouTube link to the hearing.  I noticed there were a lot more views early on then there were for the House meeting on March 7..

https://www.youtube.com/watch?v=MxnyKt6-BhU 

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Nancy Anthracite

On Wednesday, March 15, 2023 6:32:42 PM EDT Nancy Anthracite wrote:

> The DOD folks HATED their EHR.  I think anything would be better. 

>

> In the commercial sector, they mostly know Cerner and Epic and it is all they

> know and it bills well for them.  The VA has something to compare it to AND

> VistA has far more capabilities, some of which are not those of an EHR.  VistA 

> was designed by users in the VA for patient care to accomplish what they need

> so it is no wonder Cerner can't hold a candle to it.  The VA should charge

> Oracel and Cerner for helping them to make a better EHR!

>

> I was amazed that Mr. McCune would repeat that old saw that M needs to go.

> Most who testify don't do that any more because they know it can be shot full

> of holes.  Surely he has been told that Epic is written in M and many other

> systems use it.  I am sure he has some sort of twisted justification in his

> head for thinking what he is saying is true or he would not testify that way

> under oath!

>

>  I noticed that Secretary Shulkin  began to learned more, his testimony

> changed so he would technically not be spreading falsehoods any longer.  I

> think Mr. McCune at least needs to do the same.

>

> I know that Mr. McCune is frustrated that he cannot hire M developers to meet

> his standards, but I think that Robert Baker addressed those issues. But,

> nobody heard anything in the press about the testimony of the second panel and

> I venture that if it was even heard by anyone in the Senate, it was dismissed

> as it did not fit their agenda to continue to use VistA.  Repeatedly saying

> that Cerner works in the private sector so it is good, does not make it great

> or good for the VA.

>

> > Very different tone than the House hearing.

[ivaldes]

*VistA works in the private sector, so it is good 

Fixed that for you. 

[Steven L]

Well Dr Evans said a few months -- so let's see what happens.    Don't know if Ann Arbor will move forward with this, which is my residency haunts.  

Cerner/VA may rectify the actual performance issues of the product and even be more appropriately responsive to opened tickets.

That doesn't take away the baseline issue that Cerner COTS is replacing a very specialized VistA EHR that's highly regarded by its end users.   Yes, VistA is old and the GUI is exceedingly outdated; but it's a known commodity and works well enough.   This whole inter-op goal with DoD really is not needed beyond the shared sites.   We don't have interop with other systems on the commercial side and read-only for most of Epic -- and do just fine with exchanges.    

Change management has never been a strong suit of the VA and those EHR satisfaction scores are going to be hard to replace for quite a while after deployment.

On Fri, Mar 17, 2023 at 9:42 AM ivaldes <ival...@gmail.com> wrote:

*VistA works in the private sector, so it is good 

Fixed that for you. 

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[Nancy Anthracite]

I wonder, Steven, if you are aware that the GUI needs to be 508 compliant,
i.e., it needs to do all of the things it needs to do for those who are blind
or color blind as well as the typical user. It makes things much more of a
challenge. I wonder if Oracle Cerner is 508 compliant.

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Nancy Anthracite

> > <https://groups.google.com/d/msgid/hardhats/00c80b35-68a5-4669-8181-efdda1f02aecn%40googlegroups.com?utm_medium=email&utm_source=footer>
> > .
> >
>
>

[Steven L]

Yes, it's an additional feature challenge that's more an issue to new CCOW apps than CPRS vXX (like when MHeV or GuiMail came about).  Good question on Cerner-Millennium.