Pentagon’s Electronic Health Record Not Ready for Initial Use Until 2017

Bob Brewin | NextGov | November 19, 2013

The Defense Department will not start deploying its modernized electronic health record until 2017, nine years after President Obama called on the Pentagon and the Veterans Affairs Department to develop a joint EHR.

The joint effort was abandoned in February when estimated costs spiraled to $28 billion. The Defense EHR is expected to cost between $4 billion and $5 billion over five years, based on industry estimates.

The Navy will run the Defense EHR procurement with a single award to a systems integrator that will provide commercial EHR software, according to presentations at an Oct. 31 industry day run by the Space and Naval Warfare Systems Command-Systems Center Atlantic. The Pentagon on Sept. 13 named Christopher Miller, former executive director of the SPAWAR Systems Center Atlantic, to serve as program executive officer of the new Defense Healthcare Management Systems Modernization -- or DHMSM -- project to develop the EHR.

Open Health News' Take: 

This was an excellent article, as usual, by Bob Brewin. Several items in the article caught my attention and raised some questions in my mind.

At the industry day, Christopher Miller said "the new EHR will replace the Armed Forces Health Longitudinal Technology Application (AHLTA) system." Does this mean that the CHCS system remains in place and only the front end AHLTA system is to be replaced?

“Initial capability fielding will occur by 2017,” SPAWAR said. "The timeline for full operational capability may be dependent on the solution." So it will take four years to develop and just begin the initial rollout - the the date for completion is not mentioned. Why  would the government [or anyone] ever want to sign a contract like that?

In response to another question, SPAWAR revealed that the integrator will play a key role in developing the new EHR. The DoD CHCS system already deployed is basically an old version of the highly successful 'open source' or public domain VistA system used at the VA and many other others. Why would DoD avoid use of VistA and pay billions to 'develop' a new EHR?

SPAWAR said foreign vendors can participate in bids for the Defense EHR. Really?! So a system that will contain information on all our military members, their locations/units, etc. may be contracted out to a foreign entity?

"Despite this wide list, multiple industry sources who declined to be identified told Nextgov most integrators planning a bid hoped to partner with Madison, Wis.-based Epic Systems..." All sorts of red flags, unfortunately, go up when it appears a particular company's product has already been pre-selected.

Steve Harnig, the DHMSM contracting officer said that he anticipates three draft requests for proposal will be released between January and May of 2014. He did not provide a date for release of the final RFP. So, any knee jerk reactions or concerns one might have are tempered by the fact that the RFP and award may be 6-12 months away.

DHA needs to operate AHLTA and CHCS until 2017 and put out a notice on Oct. 30 that it plans to award a sustainment contract next March that could be worth just under $1 billion based on current operating budgets of $765 million a year. Why not use the funding to help upgrade the old CHCS [VistA derivative]software with many of the enhancements already developed and put in place by the VA.

Peter Groen, Senior Editor, OHNews