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In a pair of op-eds published in the Federal News Network, former Veterans Affairs Deputy Chief Information Officer Ed Meagher offered his take on the agency’s beleaguered attempts to update its electronic health record system.  

In short, said Meagher, the VA’s legacy EHR, 7. explain the folic acid campaign and the benefits of the campaign VistA “needs to be modernized, not replaced.”  

As he explained, “VistA meets all of VA’s current needs. It does need to be ‘replatformed’ and key elements need to be modernized, but those efforts were underway, at several orders of magnitude lower cost and risk, when the Cerner system was imposed on the VA.  

“No amount of good intentions, hard work, heroic management, relentless oversight or endless funding will be able to overcome the fatal flaws of this massive, misbegotten program,” Meagher added.  


Meagher, who served as deputy CIO at the VA from 2000 through 2006, and briefly as the agency’s chief technology officer in 2006, has been a longtime critic of the VA’s plans for an EHR overhaul.

“VistA represents 30 years’ worth of knowledge, experience, data standardization, education, integration, reliability, research, institutional memory and best practices. Much of this will be lost or degraded under the Cerner system,” he wrote in his first op-ed, published October 15.  

He also called the VA’s report following its three-month strategic review “very disappointing,” given what he saw as a lack of consideration about the EHR modernization contract.

“Instead, a laundry list of high-level issues were identified, and high-level remedies recommended. At the heart of each of these remedies was the belief that better management, better oversight and just plain trying harder would ultimately succeed,” he said.  

In short, Meagher said, the replacement plan is a “self-inflicted wound that if allowed to proceed will fester, degrade and ultimately critically damage the VA’s ability to meet its mission.”  

At the same time, he acknowledged in his second op-ed, published this week, that stopping the EHRM program will likely mean lawsuits, criticism and degradation of trust.  

With that in mind, he offered VA leadership “specific recommendations,” including:  

“The very best advice I can offer you is that in this moment it may appear that staying the course is your best option and that halting this multi-billion-dollar juggernaut would seem like failure and a waste of money and the efforts of many dedicated and committed people. That is not the case,” said Meagher.  


VistA has been criticized for being outdated, and lacking ease of interoperability with the Department of Defense.  

But, as Healthcare IT News has reported, the homegrown EHR system is actually relatively well-liked, particularly by its users.  

“When people really look at the history of VA, it has over 20 to 25 years of creating health informatics. It’s elevated the functionality requirements over time,” said Deanne Clark, senior health informatics consultant at DSS, in 2017. “VA has been working with end users to really understand the software and users.”  


“In the long run, when your servant leadership will be judged, when your pluses and minuses will be summed, it only matters that you do the right thing, for the right reasons, at the right time,” wrote Meagher in his second op-ed.


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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