Three Trump advisors had a role in evaluating Cerner’s $16 billion contract to build a new health record system for the Department of Veterans Affairs, according to a report released by the Government Accountability Office on Thursday.

Referred to in news reports as the “Mar-a-Lago crowd,” the trio of Marvel Chairman Ike Perlmutter, Palm Beach doctor Bruce Moskowitz and attorney Marc Sherman had a hand in some of the key decisions made by the VA.

Formal officials interviewed by the GAO said the trio had influence due to their connection to President Donald Trump — Perlmutter is a longtime acquaintance — but said VA officials still made decisions independently. One former official said the trio created a “shadow reporting structure” where they served as stakeholders without a formal role, according to the report.

The GAO analyzed 223 email exchanges between the trio and VA. Of them, 77 mentioned some aspect of the Cerner project or interoperability.

The Mar-a-Lago crowd’s input may have in part contributed to the “strategic pause” the VA took in late 2017, after it had begun to negotiate a contract with Cerner earlier that year, a former official said in the report. But the time may have also been used to ensure the contract was comprehensive.

In June of 2017, former VA Secretary David Shulkin signed a “Determination and Findings” to be able to solicit Cerner directly to build a new electronic health record system to replace the VA’s legacy VistA system. The reason for this unique arrangement, the VA said, was because Cerner was already developing a health record system for the Department of Defense, and the two agencies wanted their systems to be interoperable.

The trio became involved with the Cerner contract later that year. They provided VA officials feedback on the interoperability and usability of the proposed health record system, and provided feedback on the draft contract language, according to the report.

For example, Moskowitz participated in a November, 2017 call between the VA, the MITRE Corporation and five CIOs from private organizations. When former VA CIO Scott Blackburn suggested to Moskowitz and Sherman that they hold another call with the five executives,  Moskowitz wrote that “we are committed to your adoption of Cerner…” but “being rushed into a contract without due diligence on our part would be problematic.”

Moskowitz and Sherman also stated that they were not comfortable with the contract and did not have confidence in the VA team, according to the report.

In January of 2018, MITRE officials traveled to West Palm Beach to discuss the Cerner solution with Moskowitz. He was only familiar with a different, older Cerner system through his experience as an internist. Sherman also participated in the meeting over the phone.

One month later, Shulkin and his chief of staff met with Perlmutter, Moskowitz, and Sherman in West Palm Beach to respond to concerns they had raised over Cerner’s voice recognition, lab data, ability to catch duplication of tests and medications, and other technical aspects.

In March, Shulkin was ousted from his role as VA secretary, writing in a New York Times op-ed that “…the environment in Washington has turned so toxic, chaotic, disrespectful and subversive that it became impossible for me to accomplish the important work that our veterans need and deserve.”

The report refers to other efforts where the trio was involved, including a suicide awareness campaign the agency was conducting in conjunction with Johnson & Johnson. In November of 2017, Shulkin rung the closing bell at the New York Stock Exchange, in part to promote this campaign. Marvel Entertainment and Disney were also named as collaborators, with Marvel character Captain America making an appearance.

A month prior, Perlmutter emailed VA officials to indicate “we” are now confirmed to ring the bell at the New York Stock Exchange and that he had arranged for Marvel characters to be shown at the event, according to the report.

Perlmutter, Sherman and Moskowitz told the GAO they merely provided advice and introductions when asked. They maintained that they didn’t have a formal role at the VA or any decision-making authority.

Photo credit: Bill Oxford, Getty Images

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