I assume you are aware that the Indian Health Service is searching for a replacement Electronic Health Record system after the VA announced that they will be transitioning to Cerner. The RFI is available here https://www.fbo.gov/index?s=opportunity&mode=form&id=48302a25e571cc5c8bf47bf157988893&tab=core&_cview=0T
openemr consortium to the rescue
OpenEMR consortium is planning to go for this RFI. Have touched base with Lou to start planning. Due 2/1 and a lot of questions, so will hopefully get this in.