Is $9B Cerner deal good for DoD?

Some industry insiders have big doubts
By Bernie Monegain
10:48 AM
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Cerner headquarters

It might seem like a bit of Monday morning quarterbacking, but industry insiders are weighing in on the $9B contract the Department of Defense signed with EHR giant Cerner, and some are suggesting the government could have finessed a better play. 

Indeed, the announcement comes at the same time that Congress and the Administration are heavily invested in finding the answer to the question: How is it that most of the systems in use today still don't talk to each other after $30 billion being invested?

"At the front end, it strikes me as unfortunate and puzzling that we're about to put another $10B – conservatively – into one of the very systems responsible for the supposedly unacceptable status quo," Dan Haley, vice president, government and regulatory affairs at cloud-based health IT company athenahealth, told Healthcare IT News on Wednesday, hours before DoD announced its selection.

[Related: EHR go-live gone wrong.]

To Haley, that reaction was not particular to Cerner, Epic or Allscripts, the three contenders left in the running for the 10-year government contract. Regardless of the vendor, he said, it calls to mind the old insanity saw about repeatedly doing the same thing and expecting different results.

"The finalists are all very good, very credible purveyors of data software systems that aren't very good at exchanging information outside of their platforms," he added. "Not because they don't want to be, but because they're not built for that. They're pre-Internet platforms. They were literally created to share information within the confines of a closed network. And now they're jerry-rigged to share information outside themselves."

That, he says, is an expensive proposition and Haley has some influential company to bolster his position.

Back in February the Center for New American Security released a report that urged DoD to choose an open-source EHR system that would be "extensible, flexible and easy to safely modify and upgrade as technology improves and interoperability demands evolve."

"DoD is about to procure another major electronic (health records) system that 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," 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."

The authors of the report urged DoD to show some leadership.

"We believe that, like in so many other aspects of our society, DoD could play a leadership role," they wrote. "It could catalyze expectations, model behavior, and deliver measurable outcomes far outside its five walls. Nowhere is this more true, more necessary, and more far-reaching than the modernization of healthcare services."

Retired Army Gen. H. Hugh Shelton, Stephen L. Ondra and Peter L. Levin wrote the report.

Shelton, a former chairman of the Joint Chiefs of Staff, and is now the chairman of RedHat Software. Ondra is a former senior advisor for health information in the White House Office of Science and Technology Policy, and is today senior vice president and chief medical officer of Health Care Service Corporation. Levin is a former CTO at the Department of Veterans Affairs, and currently the co-founder and chief executive officer of Amida Technology Solution.

The DoD's request for proposals precluded a bid from athenahealth or similar cloud-based companies, Haley said. The so-called "gating criteria" made that clear by "using the term 'best of suite solution,' which our contracting people told us was code for single platform, which means static software."

He also noted that a team led by PwC that included Google and open-source software company Medsphere was knocked out of the competition after the first round of review.

"How is it that in 2015 anyone thinks it's rational to contemplate a 10-year implementation of a piece of software?" he asked. "Think about the rate at which this kind of technology evolves. The proposition that it will be obsolete before it's fully implemented is not a guess. It's a certainty."

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