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DoD, VA Spent Bulk of 2012 iEHR Budget on Support Contracts

The VA and DoD’s iEHR project may or may not come together, but it seems clear that at least one party is getting ahead — the vendors the agencies retained to support the project.

A new report from the Interagency Program Office concludes that the two agencies spent more than $300 million funding support contracts for iEHR work in 2012.  The IPO’s job is  to modernize the Military Health System’s EMR software.

DoD and the VA have been working to build a joint integrated EMR, known as the iEHR, since 2009. The idea is to build an EMR which allows every service member to have and maintain a single personal electronic health record through their career and lifetime.

However, to say the project has been troubled is an understatement, with changes of strategy riddling the effort throughout its lifespan.

In February, for example, the iEHR project was halted, with officials electing to make 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.

Most recently, the DoD announced that it was looking for contractors that can support its current EMR, AHLTA, through 2018.

All  I can say is that if you’re following all of this you’re way ahead of me. With so many switches in direction, I can’t imagine anything lasting and good coming out of the process. Maybe you have to be military to get it. As for me, I see a strategy process that seems to be governed by something resembling a coin flip.

November 27, 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.

DoD Official Says Agency *Might* Select VistA Derivative

While it appears to be an outside shot, it’s possible that the Department of Defense might still consider a derivative of the VistA EMR for its VA EMR integration project, though a straight ahead VistA implementation sounds like it may be out of the question.

At a briefing by DoD, Under Secretary for Acquisition, Technology and Logistics Frank Kendall said that while using and modernizing VistA was a “reasonable decision” for VA, it’s necessarily as bright an idea for the DoD.

After doing market research, DoD technology leaders have decided that they’ll consider a mix of competing commercial products as well as Vista-based systems, and have taken in about 20 pitches from EMR vendors.

“Three of them were from VistA-based approaches, and the rest were from other approaches,” Kendall said. “So we think we have a rich field to pick from, and we can make a best value determination for DoD.”

When asked how much the DoD’s next EMR move is going to cost, Kendall did a bit of a bob and weave, saying that seamlessly integrated data is funded in the ’13 and ’14 budgets, without naming a number for those projects or long-term costs.

OK folks. You know what?  This whole thing really ticks me off — how about you?

I don’t know why the DoD is so dismissive of VistA, but despite its colossal failures with AHLTA and the death of the iEHR project, people there still seem to think they should pursue their own course rather than go with what’s been working at the VA.

And as an American taxpayer, much less a health IT analyst, I’m really tired of hearing the leadership at DoD justify their shaky moves in the EMR arena.

Come on, Mr. Kendall. Why won’t you be more specific about the costs of your health IT initiative?  Perhaps it’s because VistA-based products could cost 10 times less than, say, an Epic installation and you don’t want annoying editors like me bugging you about it?

Apparently even blistering critiques by your colleagues haven’t moved leaders like you off of your entrenched commercial approach to EMR integration.  I guess it’ll take a memo from on high — apparently one from President Obama doesn’t suffice — to get the generalissimos of HIT at the DoD to try something that might work.

June 20, 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.

DoD, VA Plan To Streamline EMR Integration Effort

The Department of Defense and VA have decided to change the way they integrate their two EMRs, in an effort they say will lower the cost and speed the pace of interoperating.  The new approach is expected to offer at least partial functionality by 2014, rather than forcing the two agencies to wait until 2017, reports FederalNewsRadio.com.

Rather than sticking to their current course, which involves a massive effort to integrate their respective EMRs into a single system, health IT leaders will attempt to make more short term  progress.

To date, the DoD and VA have been working on common requirements and data standards and developing a shared enterprise service bus, all in the service of creating a single system. Agency leaders had estimated that the existing project would cost $4 billion.

The new plan, while keeping the larger goal of integrating by 2017, will include efforts to use existing solutions to get to interoperability quickly. Leaders expect their new direction to be considerably cheaper.

By the end of this year, the two departments will begin sharing a common UI, with the rollout beginning in seven DoD and VA wounded warrior polytrauma centers. Then, by  2014, the VA and DoD expect to be exchanging seven types of critical data, including lab results, clinical notes and allergies. The VA and DoD will accomplish this by standardizing the day their systems currently use, the VA’s chief information officer told FederalNewsRadio.com.

Another key component of the two agencies’ efforts is establishing a common system for identity management.  The identity management system is drawing on the massive Defense Manpower Data Center storehouse of personnel informaton operated by the DoD.

February 12, 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.

New Open-Source GUI Can Display Multiple EMRs

A non-profit focused on HIT has released an open-source graphical user interface which will provide a common view for patient information from multiple EMRs — a very useful trick if the software delivers what it promises.

The interface, Janus, was created as part of an interoperability program designed to link Department of Defense and VA data.  Right now, Janus is deployed at the VA Pacific Islands Health Care System/Triper Army Medical Center and clinics at James A. Lovell Federal Health Care System.

This seems like a great idea. If doctors in private medical settings could look at multiple EMR outputs at one time, I’m sure they’d be grateful.  After all, it can’t be much fun going from EMR to EMR as you travel from one hospital to another.

Such a unified view would probably save lives, ultimately, as it’d make it easier for doctors to quickly spot problems and review cases distributed across hospitals and clinics. Oh, and reduce doctor burnout too.

Though I’m a big fan of open source efforts, I’m sorry to say that I doubt it will make a dent in the way hospital IT departments and commercial EMRs are deployed.  Unfortunately, most vendors seem to feel they have more to gain by creating silos than making data sharing easy.

Still, it’s good to hear that the VA and DoD are doing something to interoperate. The two have been notorious for spending billions of bucks on integration projects that go nowhere, especially here in the healthcare arena.

The DoD’s AHLTA EMR project alone consumed 13 years and $2 billion, according to one account. The project went wrong due to poor planning and what sounds like arrogance (a failure to appreciate the “significant complexity” of the program), the Government Accountability Office concluded in 2010.

May 30, 2012 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.