One year after Cerner abandoned its EHR implementation project at Girard Medical Center, the two don't appear to be any closer to a settlement of their legal struggle.

While both Girard, a 35-bed hospital in Girard, Kan., and Cerner have declined to comment on the pending litigation, court documents provide a detailed account of the conflict between the hospital and vendor over the past two years.

According to a complaint filed in U.S. District Court in Kansas City, Mo., Girard Medical Center, a rural Kansas hospital serving primarily uninsured patients and the elderly, signed a series of agreements in September 2010 for the purchase of an all in-one electronic health record system with Cerner, a Kansas City, Mo.-based healthcare information technology corporation.

Specializing in integrated electronic health records, computerized physician order entry and financial information in one system for hospitals and health systems, Cerner is one of the top EHR vendors in the country, according to KLAS Enterprises, a healthcare technology research firm that recently rate Cerner No. 2 after No. 1 Epic for market share for hospitals with more than 200 beds.

The complaint alleges that Cerner met with Girard's board of trustees in August 2010, asking the hospital to see Cerner as a "trusted vendor/partner," which would implement a "fully integrated" EHR solution by Sept. 1, 2011 in order for Girard to qualify for the federal government's meaningful use requirements. Like other hospitals across the country, Girard would rely on the Medicare and Medicaid EHR incentive payments to subsidize the EHR.

Yet over the next year, discrepancies arose between what Cerner was able to deliver and what the initial contract proposed. For instance, the hospital claims price quotes were inaccurate; a microbiology module of the system, originally quoted at $24,000 increased to $70,000. Promised components were being dropped; "time and attendance" functionality that was fundamental to the hospital's decision to purchase Cerner's system was later revealed not to be included. And staff at the site lacked the experience to implement the system.

But this last example underscores how difficult it is to point fingers in the quarrel. Though Girard's lawsuit blames Cerner employees for a lack of "basic maturity" and healthcare experience, Girard had no IT team of its own to supervise the implementation.

"This is not like installing Microsoft Windows on your computer," notes Sean Wieland, a PiperJaffray research analyst specializing in the health IT market. "No two EHR implementations are alike. It requires an enormous amount of work by both the hospital and the vendor. It's going to require staff from the hospital to set up the tables and the master files to teach the EHR system how that individual hospital does business."

In an interview with CIO Journal, Girard officials admitted they lacked the in-house expertise – such as healthcare informaticists and chief medical information officers –  to watch and work with Cerner during the project.

Neither side has couched their frustration. According to Girard's filing: "Hospital provided notice to Cerner that on several occasions that it was in breach of the agreement and was not fulfilling its promises, and that hospital had recognized that Cerner had inaccurately represented the system and the implementation of the system to induce Hospital to enter into the agreement."

Among the notices was an August email from CEO Michael Payne to Eric Geis of Cerner, providing a detailed list of ongoing issues. 

In response, Cerner representatives notified the hospital of their desire to abandon the project and discontinue their services. Cerner left Girard in September 2011, its scheduled completion and departure date, but with no tangible work product to show for a year's work and with more than $1.2M in payments according to the court documents.

Girard did not qualify for the government incentive payments.

In the aftermath of the fiasco, Girard filed a court complaint against Cerner in February 2012, demanding reimbursement of the funds it poured into the failed system. Payne has since brought in a "vendor neutral" consulting firm to help the hospital move forward with its EHR program. 

On March 23, 2012, the U.S. District Court of Kansas City upheld a settlement of the initial 2010 contract and ruled that the situation would be handled through arbitration.

Given one year to work things out, the two parties have yet to arrive at a compromise. Girard and Cerner must submit a report of an agreement to the court by March 23, 2013.