Defense official backs commercial software for joint health record

The Defense Department views commercial software as the first choice for development of an electronic health record system jointly with the Veterans Affairs Department, a top Defense official told a congressional hearing on Wednesday.

Elizabeth McGrath, Defense deputy chief management officer, said an agreement for a joint electronic record reached on March 17 by Defense Secretary Robert Gates and VA Secretary Eric Shinseki includes development of a common architecture, common data standards and consolidation of data centers. She testified at a hearing of the House Armed Services Committee Subcommittee on Emerging Threats and Capabilities.

In response to a question from Rep. Susan Davis, D-Calif., McGrath said both departments agreed to pursue development and acquisition of the new, joint electronic health record with the focus on acquisition more than development.

McGrath said Defense "will look first" at commercial software for the health record, followed by adoption of existing Defense and VA applications, with the last choice being in-house development.

McGrath's emphasis on commercial software for the joint record conflicts with the open-source software approach backed by Shinseki and VA Chief Information Officer Roger Baker. On April 1, Shinseki said an open-source approach to modernization of Veterans Integrated System Technology Architecture, the department's current electronic health record, provides clinicians with the best tools available, including those developed by commercial firms.

Baker said the open-source approach will "ensure that vendors of proprietary products can easily and confidently integrate their products with VistA to make them available for VA to purchase and use in our facilities."

A former VA official who declined to be identified said by putting commercial software first, McGrath gave tacit endorsement to a suggestion made this February by five Wisconsin lawmakers that both departments consider a single, commercial health record system, one that involves Wisconsin-based Epic Systems Corp., a major vendor of such systems.

Opting for commercial software for the joint record could mean a big pay day for Epic, the former VA official said. Kaiser Permanente, the largest private health care provider in the country, paid Epic $4 billion to develop an electronic health record to serve 8.3 million patients, or half the number of patients covered by the joint Defense/VA system.