# Integrating Rapid Cycle Evaluation to Improve Cerner Implementation

> **NIH VA I50** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2021 · —

## Abstract

Project Background: VA recently contracted with the Cerner Corporation to replace its existing electronic
health record (EHR) in a transformation that is expected to last ten years and cost $16 billion. While EHR
modernization (EHRM) offers an opportunity to improve systems of care, these transitions are complex
undertakings that disrupt multiple sociotechnical systems and challenge clinicians who rely on the EHR to
provide patient care. Prior studies have found that EHR transitions are deeply disruptive and impact frontline
clinicians' performance and well-being. Cerner's change management plan is guiding EHRM, with limited input
from frontline VA clinicians. These EHR change management efforts must be evaluated to learn from frontline
clinicians, identify ways to support clinical teams undergoing EHRM, and mitigate negative consequences.
Project Objectives: The primary goal of this proposal is to optimize EHRM outcomes by identifying and
promoting practices that clinical teams can employ to complement Cerner's change management approach.
Cerner will replace the existing EHR in a series of rolling waves and we will apply principles of Rapid Cycle
Evaluation to evaluate and progressively improve EHRM during this phased approach. We have partnered with
the Office of EHRM (OEHRM) to design an evaluation that will engage clinicians in EHRM, improve fit between
clinical processes and the new EHR, and design strategies that help build resiliency to the disruption caused
by EHRM. Our specific aims are to:
 Aim 1: Conduct a formative evaluation to identify best practices that support EHRM.
 Evaluate pre-implementation, implementation, and sustainment at initial EHRM sites using mixed methods
 to identify practices to improve EHRM outcomes.
 Aim 2: Develop consensus on strategies that VA can implement to optimize EHRM outcomes.
 Use consensus methods with an expert panel convened by PROVEN to develop recommendations for
 practices that VA clinical teams can use to augment Cerner's change management and improve EHRM.
 Aim 3: Design and pilot test a multicomponent strategy to improve EHRM outcomes.
 Design a multicomponent strategy that includes best practices identified in Aims 1 and 2 and use OEHRM
 networks to pilot test the strategy while assessing key implementation outcomes.
Project Methods: In Aim 1, we will conduct a formative evaluation that uses mixed methods, including (1)
workflow evaluation to compare current versus new Cerner workflows; (2) surveys to assess clinical teams'
change readiness, clinician experience, and EHR proficiency; (3) interviews, reflections and observations with
clinical team members to identify strategies used to support EHRM; and (4) EHR log data to assess EHR
proficiency. We will work with teams to synthesize mixed methods results and conduct current state and gap
analyses and develop site specific action plans. In Aim 2, we will use expert panel methods to interpret
information from Aim 1 and develop consensus on stra...

## Key facts

- **NIH application ID:** 10178440
- **Project number:** 1I50HX003186-01A1
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** Seppo T Rinne
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-01-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178440

## Citation

> US National Institutes of Health, RePORTER application 10178440, Integrating Rapid Cycle Evaluation to Improve Cerner Implementation (1I50HX003186-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10178440. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*