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 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.