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Florida-based AdventHealth plans to replace its Cerner electronic health record (EHR) system with rival Epic’s.

One of the largest faith-based health systems in the country, AdventHealth operates 50 hospital campuses across a dozen states. The health system employs more than 80,000 people who serve more than 5 million patients annually and reports nearly $20 billion in annual revenue.

The health system first signed a deal with Cerner in 2002 when it was known as Adventist Health System.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

AdventHealth will begin the transition in March and will eventually roll Epic’s EHR out to 1,200 care sites. The work is expected to be completed in about three years, the health system said.

In a press release issued Tuesday, AdventHealth said it plans to install a single, integrated Epic EHR and revenue cycle management system across all of its acute care, physician practice, ambulatory, urgent care, home health and hospice facilities.

Epic’s Community Connect program will also allow AdventHealth to extend its EHR system to affiliated providers as part of the integrated platform, according to AdventHealth.

“Our journey to become a consumer-focused clinical company requires a fully connected network throughout our entire enterprise,” Terry Shaw, president and CEO for AdventHealth, said in a statement. “Connecting our network with a robust, integrated health record platform will give our caregivers access to the clinical information they need at the point of care and ultimately advance our consumer promises through a more seamless experience for those we serve.”

In an emailed statement, Cerner confirmed the changeover. “AdventHealth has made the business decision to transition over the next few years management of its EHR and revenue cycle management system to another supplier. The shift is expected to take up to five years and Cerner is committed to working closely with AdventHealth to continue delivering superior health care technology solutions throughout the transition,” the company said.

Anonymous Reddit posters predicted the change months ago, saying that the health system was frustrated with integration issues with Cerner’s ambulatory solution and revenue cycle functionalities. HIStalk first reported the Reddit posts regarding Cerner and AdventHealth.

One Reddit user said AdventHealth staff felt the health system was on the “back burner” since Cerner signed massive projects with the departments of Defense and Veterans Affairs.

It’s unclear what the loss of a big EHR client will mean for health IT company Cerner’s annual revenue or earnings.

The company continues efforts to turn its financial picture around and improve its operating performance.

Almost a year ago, activist investor Starboard Value stepped in, and Cerner reached a settlement with the hedge fund to add new directors to its board and buy back more of its shares. Cerner also agreed to take steps to improve operations and committed to hitting certain operating targets.

The new agreement between Cerner and Starboard Value, which has a 1.2% stake in the company, was seen as welcome news by many financial analysts as a plan to increase the company’s profitability.

Cerner’s full-year 2019 bookings were down 11% compared to 2018 bookings, from $6.72 billion to $5.99 billion. Company executives said during their full-year and fourth-quarter earnings call that the decline in bookings was primarily driven by the company being more selective in the types of contracts it pursues, which led to fewer large, long-term outsourcing contracts.

Congressional Democrats said they felt blindsided by the Department of Veterans Affairs’ (VA’s) decision this week to push off its go-live date for a new $16 billion medical records system.

The House Veterans’ Affairs Subcommittee on Technology Modernization plans to hold a hearing in the next few weeks to scrutinize the VA’s decision to delay the platform’s rollout, Susie Lee, D-Nevada, chairwoman of the subcommittee, announced.

The VA had planned to flip the switch on the new electronic health record (EHR) at its first site—Mann-Grandstaff VA Medical Center in Spokane, Washington—on March 28. But the VA announced this week it’s delaying plans to commence end-user training, which may impact “going live” with its EHR in March in Washington.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

“After rigorous testing of our new EHR, the department will need more time to complete the system build and ensure clinicians and other users are properly trained on it,” VA spokesperson Christina Mandreucci told FierceHealthcare in an emailed statement.

“We believe we are 75-80% complete in this regard and will be announcing a revised ‘go-live’ schedule in the coming weeks,” she said.

Lee said during a hearing on VA’s data privacy policies Wednesday that the VA needs to be “forthright about its progress, identify concerns, and notify Congress about any challenges.”

“I’ve long said that getting it right is far more important than hitting a date on a calendar. If there needs to be a delay to get the system to a place where veterans’ lives are not at risk and VA staff are ready to use it, that’s the right thing to do,” she said.

She added, “However, I’m concerned that as we have moved closer to the go-live date, we were told repeatedly there were no show-stoppers in implementation, that testing was going great, and that things were on track.”

Politico reported that the committee’s staff said the VA had not mentioned the possibility of delay in recent meetings. When the department informed Lee of the decision, VA officials employed inconsistent explanations, committee staff told Politico.

Lee acknowledged that software development and testing conditions can change rapidly, but the committee requires “transparency and for the VA to be accountable for its actions.” 

She also noted that President Donald Trump’s proposed budget would “speed up” the EHR project rollout.

The VA signed a $10 billion deal with Cerner in May 2018 to move from the VA’s customized VistA platform to an off-the-shelf EHR to align the country’s largest health system with the Department of Defense, which has already started integrating Cerner’s MHS Genesis system.

For the VA, the Cerner EHR will replace the approximately 130 operational instances of VistA currently in use across the department. While the initial EHR contract signed with Cerner was for $10 billion, the VA has pushed the estimated 10-year cost for implementing the system past $16 billion.

The VA’s delay comes a week after a key VA EHR project leader, former VA Deputy Secretary James Byrne, was abruptly dismissed. In his five months at the agency, Byrne was a key leader updating members of Congress on the progress and challenges of the implementation.

Lawmakers on both sides of the aisle want more answers on why the department pushed off its go-live date for the multibillion dollar medical records system.

Rep. Jim Banks, R-Indiana, ranking member of the committee, said during the hearing that he supported VA Secretary Robert Wilkie’s decision to delay the EHR launch but was disappointed that no VA officials in charge of the EHR project attended Wednesday’s hearing, as lawmakers had requested.

Rep. Phil Roe, M.D., R-Tennessee, the ranking member of the House Committee on Veterans’ Affairs and a member of the subcommittee, said VA’s decision to delay the project highlighted the need for lawmakers to ramp up oversight of the project.

Sen. Jon Tester, the ranking member of the Senate Veterans’ Affairs Committee, said in a statement that, “VA must establish stable leadership to provide sufficient accountability and robust oversight of this process.”

Mark Takano, D-California, chairman of the House Veterans’ Affairs Subcommittee on Technology Modernization, said he supported VA leadership taking the time they need to get the $16 billion dollar implementation right, but leaders need to be transparent with Congress.

During Wednesday’s hearing, Paul Cunningham, the VA’s deputy assistant secretary and chief information security officer, testified that he was made aware of the EHR project delay on Tuesday.

The delay was more a “tactical decision” than a result of a lack of resources, he said, while acknowledging that the project was “outside his purview.”