When it comes to whether the U.S. Department of Veterans Affairs should replace its VistA EHR with a commercial product, our readers we nearly unanimous in their support, with the bulk of them picking Cerner over other top-shelf vendors.

In a recent Healthcare IT News poll, about 51 percent of readers said Cerner should be the VA’s choice, which aligns with a recent Black Book report that said the same thing. But while 27 percent of readers said Epic would be the best choice, there’s no clear forerunner behind Cerner.

VA Secretary David Shulkin, MD, announced in March that the agency will determine the future of its outdated VistA system by July.

[Also: VA picks two vendors to standardize agency’s clinical decision support]

Shulkin is a vocal proponent for ditching the platform and moving to a commercial EHR. And former CIO LaVerne Council has echoed those sentiments about the failed iEHR project VA and the U.S. Department of Defense attempted. The failure led to DoD replacing its homegrown EHR AHLTA with an initial $4 billion contract to Cerner, Accenture and Leidos.

“From my understanding, there is currently limited interoperability with DoD system. If an EHR designed by Cerner would allow seamlessness between the two -- why not?” one reader said.

The overwhelming number of respondents point to the need for the VA to focus on delivering care -- instead of attempting to develop and maintain an EHR system. One reader said the VA needs to “stop reinventing the wheel.”

[Also: VA finally gets transparent on veteran wait times, clinical care quality]

But what are the alternatives and benefits to keeping Vista?

Some readers lean toward hiring outside help to outsource development and support, while others think VistA needs optimization of its interface. These options would save the VA a substantial amount of money.

The VA should “hire seasoned architects and engineers with EMR experience to update it from the ground up,” one reader said. “Technical documentation writers could document every aspect of the system for continued support and maintenance.”

Other readers suggested VistA should remain in place, while the VA can install other programs to support the system. For example, a commercial health interoperability and HIE platform will create a longitudinal record that spans over all VistA sites, while connecting with DoD and other commercial partners.

“Even if the decision is made to replace VistA,” one reader suggested, “this platform would still be very applicable for data sharing and for industrial strength plumbing to fulfill the VA's Digital Health Platform strategy.”

No matter the result of the July decision, it’s clear all are in agreement that change is imminent and necessary to fix a flawed system that could better serve veterans.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com