President Donald Trump ousted Department of Veterans Affairs Secretary David Shulkin, MD, last week, after about a month of reports of agency infighting and that found Shulkin was on poor terms with the President.

While there’s still a lot to be determined for the VA, one of the most pressing issues is Shulkin didn’t sign the contract with Cerner to replace the agency’s legacy VistA EHR system before he was fired.

Shulkin had put the contract on hold for interoperability concerns, but reports said he planned to sign it the week he was fired.

So we asked Healthcare IT News readers what they thought should come next for the VA’s EHR plan, and, somewhat unsurprisingly, the majority of users want to keep VistA in place and improve the platform.

Coming in second, with just over 100 respondents, those users want VA to sign the contract with Cerner.

One respondent said that officials should provide real support for VistA and permit new releases for patches, which they said hasn’t been done for a number of years. The response was echoed by other respondents, which chastised commercial-off-the-shelf products that lack the same functionality as VistA.

[Also: Everybody hates VistA? Not its users]

“Commercial Off The Shelf (COTS) products have never measured up to the VistA at all,” said one respondent. “[There have] been very expensive efforts that have yielded nothing of use, apparently not even a lesson to the VA Management.”

“They have missed the lesson that a subject matter expert and a programmer are a powerhouse of innovation and adaptation that commercial packages cannot match,” they added.

Another user had a similar mentality: “VistA has more modules and covers more of the hospital day-to-day and more health-centric than any billing oriented EMR.”

[Also: Poll: Choosing Cerner for VA wasn't a surprise, but not necessarily the best call]

As Healthcare IT News reported in May 2017, while Congress and agency officials have repeatedly chastised the use of the legacy system, VistA users are relatively happy with the system.

When compared with private sector user complaints about clunky EHRs, VistA users have the exact opposite reactions.

Most respondents spoke to not only the usability, but also worried the features required for veteran health concerns aren’t standard with COTs platforms. And those who want to keep VistA in place said they feel hiring programmers to support and repair VistA will be much more cost-effective.

Considering that EHR rollouts are primarily successful only with user buy-in, their arguments aren’t far-fetched.

Those users in favor of dumping VistA and the Cerner contract suggested Epic or a requirement of HL7 FHIR standards to ensure interoperability. Arguably, both Epic and Cerner employ the standard in its platform.

As the VA is currently operating with Department of Defense DoD Undersecretary of Defense for Personnel and Readiness Robert Wilkie as acting secretary of the VA, the future of the Cerner contract is undetermined.

A Cerner spokesperson said Cerner defers to the VA for information on the status of the contract.

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