TRICARE kicks off procurement for Defense/VA pharmacy system

Electronic system eventually will manage 190 million prescriptions a year for the two departments.

The TRICARE Management Activity on Wednesday kicked off the process to develop a joint electronic pharmacy system for the Defense and Veterans Affairs departments with a request for information to industry for commercial products that could handle the task. The joint system would manage 190 million prescriptions a year.

TRICARE, which manages Military Health System information technology projects, said it wants a single solution to track prescription and medication orders and improve patient safety by flagging drug interactions. MHS annually fills 50 million prescriptions while VA fills 140 million -- 32 million a year in hospitals and clinics and 108 million through seven mail order pharmacies.

Industry sources, who declined to be identified, said the ability to handle this scale of transactions, which makes the program the largest pharmacy system in the world, will be a key criteria as the procurement process moves forward.

TRICARE wants a pharmacy system with hooks to other systems, including electronic health records, automated pill dispensing machines and drug company systems. The joint pharmacy system will need to track medications tagged with both bar codes and radio frequency identification chips and support an interface to package tracking systems used by the U.S. Postal Service and United Parcel Service.

The pharmacy system is the first project the two departments will conduct under a joint electronic health record project approved in May, and is formally called the integrated Electronic Health Record (iEHR) Pharmacy initiative.

The request for information also offers insight into the structure of the overall iEHR planned for the two departments. Both will use common applications for health records, document management, emergency room management, lab data and blood management access through a common graphical user interface, according to a chart included with the RFI.

Both MHS and VA have unique functions that will be handled as separate applications. These include battlefield care, obstetrics and pediatrics for MHS and nursing home, long-term care and nursing homes for VA.

Computer Sciences Corp. runs the MHS pharmacy data transaction service under a 51-month, $95 million contract awarded in October 2010. VA developed its pharmacy systems internally in its Veterans Health Information Systems and Technology Architecture and it includes 13 applications that gather, process and store data pertaining to prescriptions and orders written and filled.

VA and MHS have failed so far in their efforts to develop a small-scale joint pharmacy system at the Capt. James A. Lovell Federal Health Care Center in North Chicago, the Government Accountability Office reported in July.

GAO said deployment of the prescription order system at Lovell also has been delayed pending high-level review at the two departments. As a result, Lovell had to hire the five full-time pharmacists to manually check individual patient records in each of the departments' electronic health record systems to identify possible harmful interactions between drugs prescribed in the two separate systems.