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

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.

At the industry day, Miller said the new EHR will replace the Armed Forces Health Longitudinal Technology Application EHR -- or AHLTA -- as well as a hospital record system from CliniComp International; the Composite Health Care System, which manages clinician order entry; and the EHR component of the Theater Medical Information Program.

The new EHR will cover 9.7 million active duty and retired personnel and their families. It will be deployed in six major medical centers, another 45 hospitals, 364 medical clinics, 282 dental clinics and more than 300 Navy ships. The EHR will also need connection to civilian systems that provide care under the TRICARE insurance plan, according to Navy Capt. John Windom, a DHMSM program manager.

While DHMSM has a goal of fielding the new EHR by 2017, in responses to questions asked by industry SPAWAR indicated it will take additional time for full deployment. “Initial capability fielding will occur by 2017,” SPAWAR said. "The timeline for full operational capability may be dependent on the solution."

In response to another question, SPAWAR revealed that the integrator will play a key role in developing the new EHR.  “DHMSM seeks to award to a single service provider / integrator (SPI) who will have full responsibility and accountability for all requirements (i.e., off-the-shelf EHR solution set and implementation/integration). “

More than 100 companies attended the industry day, with at least 10, including Computer Sciences Corp., IBM, Lockheed Martin and SAIC, fitting the system integrator description, industry sources said.

Between Oct. 25-31, DHA asked EHR vendors to showcase their systems, and 27 vendors answered the call -- a list of virtually every major player in the industry, including Allscripts Healthcare, Cerner Corp., Epic Systems, GE Healthcare, McKesson Corp., Medsphere Systems Corp,  and Siemens Medical Solutions.

VA demonstrated its Veterans Health Information Systems and Technology Architecture -- or VistA -- system. Two foreign EHR companies also participated: IntraHealth Canada of North Vancouver, British Columbia, and Orion Health of Auckland, New Zealand.  SPAWAR said foreign vendors can participate in bids for the Defense EHR.

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, which has deployed the only EHR close in scale to Defense's, a $4 billion system for Kaiser Permanente, the largest nongovernment health care provider in the nation. Kaiser operates 35 hospitals and 4,321 clinics that treat 8.6 million patients a year.

Steve Harnig, the DHMSM contracting officer said in his industry day brief 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.

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.

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