While I'm a BIG proponent of vendors being helpful, having excellent implementation methodologies, proper QA, and all that? That's mostly about, the vendor is a natural concentration point. When the vendor can add value, all their customers benefit. And having a good vendor always raises the odd of a successful implementation.
If the vendor is mediocre and the customer is excellent, that only helps increase the odds of success for that one customer.
Now it sounds like I'm arguing that Cerner is Most Responsible. When I really believe the VA is Most Responsible.
You see, an excellent customer can work with a mediocre vendor and achieve success. It's much harder for a mediocre customer to have success, even with an excellent vendor.
I said Cerner due to the fact they will ultimately take the hit; however, both are to blame. Big implementations are always problematic but some of the immature misses here begs the question why they didn't have a third party managing the implementation (selfish plug for me since I'm consulting now). Vendors (expect for Epic) never seem push back on the customer when there are missing components for a successful implementation for whatever reason.
USA can't do Healthcare IT but the MIC sure can build a badass F-22 Raptor. Get rid of the VA, or get them out of the healthcare business. aren't they redundant to Medicare anyway? Close every VA run facility. Expand the Veteran's choice program to infinity. just get the government out of the way once and for all
Cerner was a sore winner.
Epic rejoiced in losing.
The VA couldn't herd all the cats and competing interests.
Oh yeah, and Jared had his own interests.
It is very true that projects of this magnitude are problematic. That being said, the VA is notoriously unorganized and unable to manage scope on any type of project. I live in Denver and I watched the new VA hospital get built. Thr finished building is an absolute debacle. The scope was changed over a dozen times. Cost overruns were in the billions. I structure, which I have been in very recently, is impossible to navigate and makes no logical sense; there are multiple design flaws, including those that directly impact disabled people.
Implementing an EMR, whether Cerner or Epic or other, is very challenging. It requires a significant number of decisions that drive the project complexity and that drive how the organization will function when the project is done. I fully believe that the VA is unable to make the succinct decisions that are needed, which is why this program of theirs is such a cluster. I further believe that, once they finish this program, there will be an extremely high dollar overrun and the system itself will not work well. Workflows won't do what they really should do. Data exchange between agencies will be an ongoing battle and data will be lost.
Cookie cutter implementation process did not understand clinical environment, infrastructure,workflows.