Military CIOs give frank talk about EHRs

June 14, 2013 in Medical Technology

In a surprisingly candid conversation about iEHR, CIOs of the Military Health System and the U.S. Navy offered a glimpse into how their organization makes large IT decisions, most notably concerning the EHR it is looking to acquire.

“Our legacy systems are eating us alive in terms of cost of support and maintenance,” MHS CIO David Bowen said. “We’re spending 95 percent on legacy systems which only gives us 5 percent for modernization. That’s pretty deplorable.” 

What’s more, Bowen explained during the Government Health IT Conference and Exhibition closing keynote, sequestration could mean taking another $5 billion out of the MHS budget in 2014 – creating an obviously challenging backdrop against which MHS and the DoD are trying to address the whole issue around its EHR and the joint iEHR project with the VA, as well the department’s role in other military health IT initiatives such as the Healtheway HIE, the OSEHRA open source custodial agent, and the Virtual Lifetime Electronic Record (VLER).

“There’s some confusion … people said ‘you are moving away from the VA,’ That’s not true, we’re an extension of the VA,” said CDR Cayetano S. Thornton, chief information officer, Navy Medicine, (M6) deputy chief, Bureau of Medicine and Surgery, explaining that the VA’s VistA EHR system works for that department while the DoD has its own “somewhat unique” requirements. “And that bridge may be too far to actually create a data repository … it doesn’t mean we’re not talking to the VA; it’s actually the opposite.”

Thornton continued that the top priority remains information access, giving providers necessary patient data to enable continuity of care, even if the approach has changed since the onset of iEHR.

“It’s the same challenge,” he said. “Is it possible it could be VistA? Maybe. But I’ll say there are commercial grade solutions we could literally plug and play and provide the utility we need in terms of health information, and there are a couple that have market share. We’ve had at least four come in and independently analyze our needs and hands down it’s the best for us.”

Although Thornton stopped short of naming those vendors or specifying exactly how many could fulfill the DoD’s requirements, Undersecretary of Defense for Acquisition Frank Kendall said on May 22 that the department has identified 20 such EHR makers that could fit — a number that raised some eyebrows as perhaps overly optimistic. 

Bowen added that where things stand today, they don’t know how long the procurement and implementation processes will take, but they do have a concept of what that core EHR will look like, though finalizing it depends on vendor responses, what suggestions the contract winner brings, and other feedback the DoD gets. 

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