As the Department of Defense works to select a vendor for its electronic health record modernization contract, it should aim to adopt an enhanced and flexible health IT infrastructure to break the “unsustainable spiral” of increasing fee-for-service costs, according to a new report from the Center for a New American Security, EHR Intelligence reports (Bresnick, EHR Intelligence, 2/13).
Background
In August 2014, DOD issued a final solicitation for bids for the $11 billion Defense Healthcare Management Systems Modernization contract. A team of DOD civilians, military personnel and subject matter and procurement experts are evaluating the proposals.
As part of the project, DOD will replace the:
Armed Forces Health Longitudinal Technology Application, or AHLTA;
Composite Health Care System; and
Various EHR components, including AHLTA-Theater.
Vendors competing for the contract include:
A team that includes PricewaterhouseCoopers, Google, General Dynamics Information Technology, DSS and MedSphere;
A team that includes Computer Sciences Corp., a defense contractor and systems integrator, Hewlett Packard, a computer services firm, and EHR developer Allscripts;
A team that includes EHR vendor Cerner, Leidos — a government systems integrator — and Accenture Federal; and
A team that includes IBM and EHR vendor Epic, which recently unveiled a new advisory group.
DOD officials plan to make a decision on the contract by June (iHealthBeat, 1/15).
Details of Report
The CNAS report was authored by:
H. Hugh Shelton, a retired Army general and former chair of the Joint Chiefs of Staff;
Peter Levin, former CTO of the Department of Veterans Affairs (Tahir, Modern Healthcare, 2/13); and
Stephen Ondra, former senior adviser for health information in the White House Office of Science and Technology Policy (EHR Intelligence, 2/13).
The report criticized DOD’s procurement process for locking it into a 10-year agreement with a vendor.
The authors wrote, “We are concerned that a process that chooses a single commercial ‘winner,’ closed and proprietary, will inevitably lead to vendor lock and health-data isolation,” adding that DOD’s choice “may not be able to stay current with — or even lead — the state-of-the-art, or work well with parallel systems in the public or private sector.”
In an interview, Levin noted that the long-term agreement would prevent DOD from acting flexibly as technologies change (Modern Healthcare, 2/13).
Recommendation
The report recommended that DOD select an EHR system based on open-source technologies.
Rather than awarding a contract that would “hold [DOD] captive to the innovations of any single company or the services of a solitary vendor,” the department “could choose a platform that is extensible, flexible and easy to safely modify and upgrade as technology improves and interoperability demands evolve,” the authors wrote (EHR Intelligence, 2/13).
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