Coast Guard awards contract for electronic health record system

The Coast Guard awarded a $14 million contract for an electronic health record system on Tuesday to the same company that developed a network for Kaiser Permanente, the largest private health care organization in the nation.

The service awarded the project to Wisconsin-based Epic Systems Corp. to replace its current health network, which is modeled after the Composite Health Care System. CHCS is the core of AHLTA, which is the Defense Department's primary e-record system.

The Coast Guard made clear in its procurement documents that it must move away from CHCS and its graphical interface because these "systems do not meet current federal requirements for an interoperable electronic medical record."

The current systems "have outdated architecture and interfaces, and lack basic EHR features such as clinical decision support, billing, patient scheduling portals, and population health functionality," the Coast Guard wrote. "Finally, the current environment is inefficient, experiences poor user satisfaction, and has no wireless user interfaces."

Officials said they needed a new system that could work with the Nationwide Health Information Network and support the Virtual Lifetime Electronic Record, a project President Obama kicked off in April 2009 to build a joint record system for Defense and the Veterans Affairs Department.

Kaiser Permanente uses an Epic system for 8.6 million patients and 15,000 doctors who work at 36 hospitals and more than 400 clinics. The health company started exchanging patient data over NHIN with VA and Defense hospitals in San Diego in 2009.

The scale of the Coast Guard Health Services Program is far smaller than those at Kaiser or Defense or VA. The service has more than 1,000 clinicians, which include doctors, dentists, pharmacists and nurses who work at 43 clinics, and corpsmen assigned to more than 20 large cutters. Coast Guard's current system supports more than 200,000 medical personnel and more than 100,000 patient sessions annually through a thin client/server architecture.

Officials have asked Epic to install its EHR system at two or three test sites within six months and to rollout the system to other installations by October 2011. A Coast Guard spokesman said the service will not be able to provide details on its plans for the Epic system until next week. Epic officials declined to comment.

Kaiser spokeswoman Ravi Poorsina said the company's clinicians are mostly pleased with the Epic system "and never want to go back" to paper health records. It took Kaiser about six years to install the Epic software, and "it was a difficult process because of the magnitude" of the deployment, Poorsina said.

Defense is considering using a commercial system to replace AHLTA, with some speculating the Military Health System will choose Epic.

The Government Accountability Office reported on Tuesday MHS has budgeted $302 million for its new EHR in fiscal 2011 in addition to $2 billion it has spent on EHRs since 1997.

Roger Baker, chief information officer at VA, told the Senate Veterans Affairs' Committee on Tuesday there was a possibility Defense could adopt the new version of VA's Veterans Health Information Systems and Technology Architecture.