I suspect this means Cerner will be rolled out as is, whether it works for the VA or not

[Nancy Anthracite]

https://federalnewsnetwork.com/it-modernization/2025/03/va-cuts-support-work-for-new-ehr-after-canceling-hundreds-of-contracts/

--

Nancy Anthracite

[don6...@gmail.com]

Veterans Affairs' Ongoing Struggle to Modernize Its Electronic Health Record System

https://www.gao.gov/blog/veterans-affairs-ongoing-struggle-modernize-its-electronic-health-record-system 

After three unsuccessful attempts, the Department of Veterans Affairs is currently on its fourth effort to modernize its outdated electronic health records system. VA relies on its electronic health record system to manage the health care needs of nearly 9 million veterans and their families. But the department’s latest attempt to modernize this system is also delayed and faces similar issues seen in prior efforts.

[Paul Vandenberg]

VA’s efforts to replace its aging legacy system began in 2001. Its first three attempts were abandoned due to concerns about project planning, high costs, and undelivered capabilities.

I'm only aware of VistA Evolution/eHMP which was cut short when the Cerner contract was signed.

What efforts came before eHMP, and is there any solid information regarding those projects?

[ivaldes]

In the mists of time there has been CoreFLS (Core Financial and Logistics System) considered a failure ($300 million) and cancelled in 2005, the Innovations era about 2008 or so then  2011 T4 "Veterans Affairs Transformation Twenty-One Total Technology" $4 billion which didn't, then the abrupt end of T4 and the beginning of Cerner during Trump 1, then Biden doubling the taxpayer fun with the resurrection of T4NG (Transformation Twenty-One Total Technology Next Generation) $14.3-$22.3 billion with a heavy focus on Service Disabled Veteran Owned Small Business (SDVOSB) and continuation of Cerner $9.6 billion obligated and now Trump 2 which so far has been Cerner and T4NG??? The current estimate for Cerner now range from $16 billion up to $50 billion.  I think I am seeing a trend.  

All it really needs is a web client for CPRS/BCMA/Group Notes, etc. 

[Nancy Anthracite]

I have been told about even older attempts many years ago but I don't recall the details.  Some that were tuned into the goings on way back them remember and may chime in.

--

Nancy Anthracite

On Monday, March 24, 2025 3:59:58 PM EDT ivaldes wrote:

> In the mists of time there has been CoreFLS (Core Financial and Logistics

> System) considered a failure ($300 million) and cancelled in 2005, the

> Innovations era about 2008 or so then  2011 T4 "Veterans Affairs

> Transformation Twenty-One Total Technology" $4 billion which didn't, then

> the abrupt end of T4 and the beginning of Cerner during Trump 1, then Biden

> doubling the taxpayer fun with the resurrection of T4NG (Transformation

> Twenty-One Total Technology Next Generation) $14.3-$22.3 billion with a

> heavy focus on Service Disabled Veteran Owned Small Business (SDVOSB) and

> continuation of Cerner $9.6 billion obligated and now Trump 2 which so far

> has been Cerner and T4NG??? The current estimate for Cerner now range from

> $16 billion up to $50 billion.  I think I am seeing a trend. 

>

> All it really needs is a web client for CPRS/BCMA/Group Notes, etc.

>

> On Sunday, March 23, 2025 at 4:03:39 PM UTC-5 Paul Vandenberg wrote:

>

> > *VA’s efforts to replace its aging legacy system began in 2001. Its first

> > three attempts were abandoned due to concerns about project planning, high

> > costs, and undelivered capabilities.*

> >

> > I'm only aware of VistA Evolution/eHMP which was cut short when the Cerner

> > contract was signed.

> > What efforts came before eHMP, and is there any solid information

> > regarding those projects?

> >

> > On Wednesday, March 19, 2025 at 4:18:26 PM UTC-5 don6...@gmail.com wrote:

> >

> >> *Veterans Affairs' Ongoing Struggle to Modernize Its Electronic Health

> >> Record System*

> >>

> >> https://www.gao.gov/blog/veterans-affairs-ongoing-struggle-modernize-its-electronic-health-record-system 

> >> <https://www.gao.gov/blog/veterans-affairs-ongoing-struggle-modernize-its-electronic-health-record-system>

> >> *After three unsuccessful attempts, the Department of Veterans Affairs is

> >> currently on its fourth effort to modernize its outdated electronic health

> >> records system. VA relies on its electronic health record system to manage

> >> the health care needs of nearly 9 million veterans and their families. But

> >> the department’s latest attempt to modernize this system is also delayed

> >> and faces similar issues seen in prior efforts.*

> >> On Wednesday, March 19, 2025 at 7:56:37 AM UTC-4 Nancy Anthracite wrote:

> >>

> >>>

> >>> https://federalnewsnetwork.com/it-modernization/2025/03/va-cuts-support-work-for-new-ehr-after-canceling-hundreds-of-contracts/

> >>>

> >>>

> >>> Nancy Anthracite

> >>>

> >>>

>

>

[Michael O'Neill]

T4 and T4NG aren’t specific projects. They’re contract vehicles meant to provide a common methodology and process for issuing and awarding IT contracts. Hundreds of projects used T4 and T4NG. I’m not going to claim that I think they are the best way for VA to do IT contracting; just pointing out that they are not EHR modernization programs. 

I’m not sure what the “Innovations era” means. The VA Innovation Initiative (VAi2) started in 2010 and I do know something about that. It was not a EHR modernization program but a number of the projects involved VistA.

There was a VHA-led project called HMP (Health Management Platform) that pre-dated eHMP. I believe that the eHMP name came from a kind of merging of the VHA-led HMP and the OIT-led VistA Evolution programs. 

I don’t go back far enough to know the details of EHR modernization efforts before this. I believe there was a VistA Web project that came before HMP/eHMP, though.

Mike

-- 
-- 
http://groups.google.com/group/Hardhats
To unsubscribe, send email to Hardhats+u...@googlegroups.com

--- 
You received this message because you are subscribed to the Google Groups "Hardhats" group.
To unsubscribe from this group and stop receiving emails from it, send an email to hardhats+u...@googlegroups.com.
To view this discussion visit https://groups.google.com/d/msgid/hardhats/4786959.KJJECZNHGQ%40owl.

[ivaldes]

The public and many within the VA experience everything funded under “T4/T4NG” as “the modernization effort”, regardless of technical contracting nuances. 

"All it really needs is a web client for CPRS/BCMA/Group Notes..."

Remains the most common-sense, cost-effective, user-centered modernization approach no one with a billion-dollar contract seems interested in.

[Michael O'Neill]

Not sure this matters very much but for the record - no, actually no one I know at VA ever thought that T4 was “the modernization effort”. If they were aware of it at all, they may have had other opinions :) 

Mike

To view this discussion visit https://groups.google.com/d/msgid/hardhats/acfa2cc8-363a-41fb-9529-413c41ebc381n%40googlegroups.com.

[don6...@gmail.com]

I worked with David Bolduc (who wrote VPE "Victory Programming Environment") before he transferred to Tampa.  He was interested in writing a graphical front end for Windows to access VistA back then and didn't find anyone interested so he retired.

[ivaldes]

I was personally involved with many Innovations projects and T4's including advanced clinical decision support, advanced care plans, and more. It was a modernization effort to us. 

-- IV

[Skip]

To Mr. O'Neil's point, the VA hospital I was at was able to up grade our wiring from telco. to fiber optic backbone, install the routers, etc. via the T4 contract. There were other upgrades that I don't remember. The only reason I remember this one is because I learned how fiber optic cable was spliced. Which was cool.  :-)

[Michael O'Neill]

I’m sure your projects were modernization efforts, and I’d love to hear about them - much more interesting than the contract vehicles that funded them!

Mike

To view this discussion visit https://groups.google.com/d/msgid/hardhats/1fad05dc-a50b-47ea-8c47-d38f101b5fe3n%40googlegroups.com.

[Benjamin Irwin]

If you remember the history as shared by the many original Hardhats on this list, the plan to replace DHCP(VistA) started when the developers and doctors were in development and release from the very beginning.  From what I remember from the stories the "Administration" didn't want the home grown system and pushed against it then and through out its life span.

I came on the scene around 2002, and at that time the goal was to replace the VistA system with a Java/Oracle solution.  The process was started and in the research stage, but as far as I know didn't make it much further than that.

[ivaldes]

The projects I was directly involved with were interesting for their time and potentially useful but like most of the projects of those eras were not deployed and had little impact.  When T4 came onto the scene we were eventually replaced with Beltway prime contractor favorites.  I moved on to the private sector where the Astronaut team went on to do hundreds of self-funded upgrades to VistA and CPRS which we use frequently for actual patient care. We obtained MACRA/MIPS certification. The Astro-CPRS that we use has quite advanced features.  We would like to sell those upgrades to VA but so far that effort has yielded nothing.  We are currently working on an embedded, practical, new workflow for a clinical area that VistA to my knowledge has not had before or if it does it is missing important features. Hopefully in the near future I will have something to announce.