Late Breaking News
DoD Will Search for Commercial EHR Software, Not Simply Adopt VA System
By Sandra Basu
WASHINGTON - DoD will examine commercial software as the next step in its search for an electronic health record system and not merely adopt the current Veterans Health Information Systems and Technology Architecture (VistA) system used by VA, the agency recently announced.
“When we do the source selection, we may end up with a VistA derivative and be more common in software,” Frank Kendall, undersecretary for Acquisition, Technology and Logistics, explained during a press conference. “But it’s a little bit like email: We don’t have to use the same email system to send emails to each other, you know? We’re both very large organizations with a lot of cultural differences and so on, and we have to make sure that our people are brought on board and are comfortable with the product that we’re going to acquire here.”
The decision to embark on a software search came as a result of a 30-day review of DoD’s EHR efforts that was ordered by Secretary of Defense Chuck Hagel. According to a DoD statement, Hagel concluded that DoD should pursue “a full and open competition for a core set of capabilities for healthcare management software modernization.”
“Our objective is to provide the best possible healthcare for our servicemembers with continuous quality care. Our servicemembers and veterans and their families expect and deserve a seamless system to administer the benefits they have earned,” Hagel said.
Accelerated EHR Plan
The news comes as pressure has mounted on the agencies to devise a path forward in the wake of their decision earlier this year to no longer build a single integrated electronic health record system from scratch by 2017. Much to the chagrin of lawmakers, the agencies said they would instead pursue a less costly and accelerated plan that would use already existing technology to develop single, seamless integrated healthcare records that can move from DoD to VA.
Under the new plan, VA said it would continue to use a modernized version of VistA as its platform. DoD has been left to select its platform, having opted to pursue an open competition for its selection.
Hagel has suggested that, in general, DoD is not as far along as he would like in addressing President Barack Obama’s order for the two agencies to integrate their EHR systems.
At a hearing in April, he told members of the House Appropriations Defense subcommittee that he could not “defend” what the agency had so far done over the years in its EHR efforts. That was after Rep. Nita Lowey (D-NY) had pointed out that the joint iEHR effort has cost the agencies more than $1 billion over the past five years.
“I could take you down through the programs and say it hasn’t been totally wasted because these things have come out of the investment, but I will not do that. I am going to acknowledge that we are way behind. We will do better,” Hagel said.
Meanwhile, lawmakers in both the Senate and House have linked the need for a joint EHR to reducing the growing VA backlog claims.
“We request that you ensure DoD makes smart investments in the resources and manpower necessary to expedite the transition from paper to electronic records transfer,” Senate House Veterans’ Affairs committee members wrote in a letter earlier this year. “Ultimately, a common overarching information technology solution must be created to provide seamless electronic transmission of the information necessary to speed the process of benefits decisions.”
Lawmakers have questioned why DoD does not simply adopt VistA, given its popularity, but DoD officials have up to this point been unwilling to commit to VistA and why the military will not use it. During a press briefing Kendall explained that the “journey” for VA and DoD has been a little different when it comes to choosing an EHR.
“We have not had good success in the department even internally trying to do very large-scale software systems or business systems across the military services, across the military departments,” he said. “So I think this path, I think, frankly, has a higher chance of success than if we tried to force ourselves together into a single solution and negotiate every single detail of that. I think that’s a very difficult path to tread.”
Kendall also said it was “a reasonable decision” for VA to choose VistA and modernize it.“It's evolving, and VA is not going to stick with their current VistA. They’re going to go to a more capable version of that,” he said.
Meanwhile, Kendall said DoD has a “rich field to pick from” when it comes to choosing a software system.
“We did market research on this and we had about 20 responses from industry. Three of them were from VistA-based approaches, and the rest were from other approaches,” he said.
Kendall said that DoD wants to position itself to “take advantage of additional advances in terms of the functionality that’ll be in software in the future.”
“We’re going to do a competition out of which we may select VistA or some other software applications into a core capability, and then other modules of capability are added on to that as you move down the modernization path,” he said.