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DoD May Keep Its EMR Until 2018

Posted on November 13, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Though it had previously announced plans to update its system by 2017, the Department of Defense is now looking for contractors who can support its current EMR, the Armed Forces Health Longitudinal Technology Application (AHLTA), through 2018, according to iHealthBeat.

The DoD and VA have been working for years to integrate their separate systems,but seemingly have little to show for their efforts. The two sprawling agencies kicked off their effort to create an integrated record, the iEHR, back in 2009. The idea was to offer every service member to maintain a single EMR throughout their career and lifetime, iHealthBeat reports. But the effort has been something of a disaster.

The iEHR project was halted in February 2013, with officials deciding to work on making their current EMR systems more interoperable. A few months later, DoD Secretary Chuck Hagel wrote a memo stating that the agency will consider a commercial EMR system. Most recently, the DoD asked 27 EMR vendors to provide demos of possible EMR replacements, according to iHealthBeat.

In DoD’s pre-solicitation notice, DoD announced that it would extend the contract for AHLTA’s underlying Composite Healthcare System, which is the back end of the military EMR.  The Composite Health System handles laboratory tests, prescriptions and scheduling.

That being said, the DoD is also moving along with its iEHR plans once again, a gigantic project which the Interagency Program Office estimates will cost somewhere between $8 billion and $12 billion. A contractor named Systems Made Simple recently won the contract to provide systems integration and engineering support for creating  the iEHR.

Folks, if you can follow the twists and turns of this story — they’ve giving me whiplash — you’re a better person than I am. So far as I can tell, the DoD changes its mind about once a quarter as to what it really wants and needs. Seems to me that Congress ought to keep that birch rod handy that it used on HHS over the HealthCare.gov debacle. Isn’t somebody going to get this thing once and for all on track?

DoD, VA Move Closer To Joint EHR

Posted on October 24, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

It looks like the DoD and VA may yet again be making  progress toward creating an integrated health record, after a long stretch when it looked like the project was dead, according to Healthcare IT News.

This is a gigantic effort, and expenses for executing it are gigantic too. In September 2012, the Interagency Program Office estimated the final costs for the iEHR at between $8 billion to $12 billion.

The course of the project has been bumpy, with key players shifting direction more than once. Most recently, the DoD had announced in May that it was looking for an EHR on the commercial market, seemingly dropping plans for creating an iEHR with the VA. But now the two agencies have awarded a re-compete contract for creating the iEHR, HIN reports.

Last week, the Interagency Program office said that Systems Made Simple had won the contract, under which the company would provide systems integration and engineering support for creating the iEHR.  SMS had previously won the contract in 2012, but that contract called for it to bid again in a competitive process.

The idea behind the iEHR has been and continues to be creating a system that can present a single record for each military veteran, complete with all clinical information held by the two giant agencies.

However, for a time it looked like the iEHR project was dead, when the two organizations announced that they were shifting their approach to buying technology from an outside vendor. Critics — including myself  — sharply scolded the agencies when these plans came to light, with most suggesting that the new plan was doomed to fail.

Now, the integration game is on. SMS’s three main focus areas will be to establish data interoperability between the VA and DoD systems, plan a service-oriented architecture for the integration, and create terminology translation services that deliver data to users in a shared format, notes HIN.

With these goals met, SMS plans to “create data through a single, common health record between all VA and DoD medical facilities,” the company said in a statement.

Now, let’s hope that nobody in the agencies switches direction again. Let’s give this thing a chance to work, people!

DoD Official Challenges Agency’s EMR Approach

Posted on April 26, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Back in 2009, the Department of Defense and the VA began an initiative, the iEHR project, which was supposed to integrate the two sprawling agencies’ EMR systems.  That initiative came to a halt in February, with the two organizations deciding make their two independent systems more interoperable and the data contained wtihin more shareable.

At least one DoD official, however, believes that the latest effort flies in the face of President Obama’s directive that agencies adopt and use open data standards. J. Michael Gilmore, director of the DoD’s operational test and evaluation office, has sent a memo to Deputy Secretary of Defense Ashton Carter arguing that the DoD’s plan to evaluate commercial EMR systems is “manifestly inconsistent” with that order.

“The White House has repeatedly recommended that the Department take an inexpensive and direct approach to implementing the President’s open standards,” Gilmore wrote. “Unfortunately, the Department’s preference is to purchase proprietary software for so-called “core” health management functions…To adhere to the President’s agenda, the iEHR program should be reorganized and the effort to define and purchase “core” functions in the near term be abandoned.”

If the DoD actually manages to successfully implement a commercial EMR system, it “would be the exception to the rule, given the Department’s consistently poor performance whenever it has attempted wholesale replacement of existing business processes with commercially derived enterprise software,” Gilmore noted tartly.

Gilmore recommends that the DoD go the open standards route by defining and testing the iEHR architecture, then purchasing a software “layer” to connect DoD’s EMR with other providers using open standards.

The VA, meanwhile, has formally proposed that the DoD migrate from its existing AHLTA EMR to the VA’s popular VistA EMR, already in place successfully throughout the agency’s hospitals and clinics. VistA is deployed at more than 1,500 sites of care, including 152 hospitals, 965 outpatient clinics, 133 community living centers and 293 Vet Centers.