Initial report shows Pentagon EHR rollout still has big problems

A team of independent Pentagon investigators gave another poor grade to the MHS Genesis electronic health record implementation in the Pacific Northwest, according to sources familiar with an executive briefing on the report.

The Initial Operational Test and Evaluation at Madigan Army Medical Center, just outside Lakewood, Wash., found MHS Genesis remains “not effective and not suitable” — conclusions similar to those reached in an April report on three other sites, in Spokane and the Puget Sound. The latest report also said MHS Genesis was “not interoperable,” according to two individuals who saw a summary briefing provided to Stacy Cummings, the DoD official in charge of the project.

Despite the negative assessment, the surgeons-general of the four military branches have signed off on moving forward with MHS Genesis, which is running at the four Northwest sites and is planned to go live at three additional bases in California and one in Idaho next year, the two sources said.

A Pentagon official said that while Cummings has been briefed on the findings, the final report was not finished. “I expect the report to recognize significant system improvement” in response to problems that were broadcast in the April report, said David Norley, Cummings’ executive assistant.

Officials planning the next stage of the implementation are increasing training of clinicians and will have more Cerner experts on site to assist with problems. Already, officials running the implementation have reduced the average time required to respond to complaints from 84 days to fewer than six, Norley said.

But one Pacific Northwest doctor, speaking on condition of anonymity, said the fixes still required too much time. Military clinicians who attended Cerner’s annual conference in Kansas City earlier this month were impressed by the company’s capabilities, the doctor said, “but we’re lagging way behind where we should be because our processes aren’t agile enough. We’ll get there, but it’s going to take time and money.”

It isn’t clear how much the military intends to change MHS Genesis in response to complaints about usability and other issues, but Norley said the current version will be improved. In any case, he said, “the baseline solution allows more data sharing, greater patient safety features, and more cyber security protection than the legacy system it replaces.”

A Cerner spokesperson declined to comment on the report.

VA and Defense secretaries on Sept. 26 signed an agreement pledging to “align their plans, strategies and structures as they roll out a EHR system that will allow VA and DoD to share patient data seamlessly” for 18 million people covered by the two systems. They also promised to create a new organizational structure that will put the power to resolve differences in a single office.

It’s not clear how much the systems will be allowed to diverge. More similarity could mean easier transmission of patient data between DoD and VA facilities. Yet the two services meet drastically different needs for active-duty troops and veterans.

To this point, the chief of the House Veterans’ Affairs subcommittee overseeing the EHR deal complained in an Oct. 10 letter to acting VA Deputy Secretary James Byrne that the VA appeared to have abandoned its Lighthouse project, an in-house project to create an open API platform into the VA’s health system.

Rep. Jim Banks (R-Ind.) wrote that it was important for the VA to “future-proof” its Cerner acquisition with the technology so it can import software and apps that may go beyond what Cerner can provide.

VA spokesman Curt Cashour said the agency would respond to Banks’ request for information about whether the agency was still committed to the open API pledge.

VA recently issued a list comparing the Cerner modules in its contract with those in MHS Genesis.

Notably, the VA has enhanced specialty services like radiology, labs and cardiology, more interoperability functions as well as prescription drug monitoring, population health and administrative software, largely absent from MHS Genesis.

The VA contract with Cerner and its partners is approximately $10 billion, while the DoD contract currently is $4.3 billion.

David Hockney pool painting soars to $90 mln, record for living artist

An iconic 1972 painting by British artist David Hockney soared to $90.3 million at Christie’s on Thursday, smashing the record for the highest price ever paid at auction for a work by a living artist.

With Christie’s commission, “Portrait of an Artist (Pool with Two Figures),” surpassed the auction house’s pre-sale estimate of about $80 million, following a bidding war between two determined would-be buyers once the work hit $70 million.

The previous record for a work by a living artist was held by Jeff Koons’ sculpture “Balloon Dog,” which sold for $58.4 million in 2013. Hockney’s previous auction record was $28.4 million.

The 1972 work by the 81-year-old British artist, one of Hockney’s most famous paintings which depicts a man in a pink jacket looking down on another figure swimming underwater in a pool, was reported to have been consigned by British billionaire currency trader Joe Lewis.

Christie’s did not identify the seller or the successful bidder, who was bidding via telephone during a nearly 10-minute contest for the work.

Morgan Long, senior director of art investment house Fine Art Group, hailed “a great result for Christie’s,” saying it achieved its predicted $80 million price “through a combination of clever marketing and what looked like sheer determination on the part of (a) phone client to take the painting home.”

In a virtually unprecedented move for such a valuable painting, “Portrait of an Artist,” which was on exhibition at Tate Britain, the Pompidou Centre and New York’s Metropolitan Museum of Art over the past two years, was sold with no reserve, the minimum price at which the consignor agrees to sell a piece.

The price went far to boost the success of Christie’s post-war and contemporary art auction, which took in a total of $357.6 million, roughly the middle of its expected range, with 41 of the 48 lots on offer finding buyers.

“What we have learned from this week is that demand for great art remains global, with strong participation from American bidders and good activity from Europe and Asia,” Chief Executive Guillaume Cerutti said after the sale.

Other sale highlights included Francis Bacon’s “Study of Henrietta Moraes Laughing,” which sold for $21.7 million against a pre-sale estimate of $14 million to $18 million, and Alexander Calder’s “21 Feuilles Blanches,” which more than doubled its high estimate, selling for just under $18 million.

Republicans battle to defend Trump from threat of impeachment

The audition to become President Donald Trump’s most visible defender in Congress — and lead the fight against any impeachment proceedings — is in full swing.

One of Trump’s fiercest allies, Rep. Jim Jordan, on Friday began flirting openly with a bid to serve as the top Republican on the House Judiciary Committee, the panel where a flood of Democratic-led investigations, and potential impeachment, will begin.

“We’re still looking at it,” the Ohio Republican said when asked whether he would run for the post. “I’ve always been one who’s going to fight to get the truth out no matter what role I have. So we’ll just wait and see.”

Republicans’ pick will be critical for Trump and his party. The new House Democratic majority has detailed a long list of targets for investigation, from Trump’s business entanglements to his decision to fire former FBI Director James Comey. Even after Republicans were routed in the midterms, GOP leaders are vowing to aggressively defend against Democratic probes, which they’ve labeled “presidential harassment.”

The top slot on the Judiciary Committee also comes with a powerful policy portfolio. The committee has jurisdiction over immigration, gun control and abortion, as well as oversight of the Justice Department and FBI. But with Capitol Hill polarized over the president, the next ranking Republican on the House Judiciary Committee will likely be spending more time fighting for Trump than legislating with Democrats. It’s a reality that is already coloring the jockeying for the job.

Trump, in fact, has already given Jordan a boost — calling incoming GOP leader Kevin McCarthy and urging him to ensure Jordan, a longtime McCarthy adversary, got a top committee post next year. That led to whispers and speculation that Trump wanted Jordan in the Judiciary slot, though Trump has declined to explicitly endorse him.

“I would like to see Jim in a high position ’cause he deserves it,” Trump told the Daily Caller on Wednesday. “He’s fantastic, but I haven’t gotten into the endorsement or not.”

Jordan’s interest in the role has scrambled the calculus for the other GOP lawmakers eyeing the job, including Rep. Doug Collins, who’s widely perceived as the front-runner.

Collins has spent a year maneuvering meticulously to become the lead Republican on the committee. The affable Georgian has crisscrossed the country fundraising for colleagues, forged relationships with Republicans in House leadership and showcased his legislative chops by partnering with Democrats to advance high-profile legislation.

But since Election Day, when rumors of Jordan’s interest in the position began to surface, Collins has taken pains to emphasize all the ways he’s backed up Trump in investigations and on the House floor over the last two years.

Collins’ allies note that he has taken on the Justice Department over GOP allegations that senior officials were biased against Trump — an issue Jordan has championed for a year. And Collins himself says that even as he considers ways to collaborate with Democrats, he’ll relish the chance to beat back any “overreach” in their investigations of the president.

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