Is DoD's EHR modernization bound to fail?

"The system is more balkanized now than it used to be, because the cost and complexity of the installed technology deters sharing."
By Jack McCarthy
08:02 AM
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The Department of Defense's plans to spend $11 billion on a new EHR system are coming under fire.

The Defense Healthcare Management Systems Modernization, aka DHMSM, is intended to facilitate interoperable information sharing among the Department of Defense, the Department of Veterans Affairs, and private-sector healthcare providers.

Yet some are saying the system, the most expensive EHR investment of its kind, is bound for failure, while others suggest the contract itself should be delayed pending further review.

Thomas J. Verbeck, a CIO and a retired U.S. Air Force brigadier general, recently wrote that sharing data is essential for the DoD because it will speed healthcare delivery and save lives, as well as reduce healthcare costs, prevent medical errors and avoid unnecessary testing.

"But the DoD's plan will fail," Verbeck wrote in The Fayetteville Observer. "That's because most of today's EHR systems, including the bidder finalists, are designed only to work within their own system. That allows them to charge physicians and hospitals outside their system for access to your data. DoD can demand a system that seamlessly connects health data with civilian hospitals – or the VA – but it has failed to do so." 

[Another view: DoD EHR modernization to rock the marketplace.]

What's needed, Verbeck said, is to delay the award pending a congressional review.

Likewise, Loren Thompson, Chief Operating Officer of the non-profit Lexington Institute and CEO of Source Associates, said the DoD plan as now set has little hope of being interoperable.

Recent efforts to modernize government systems have all fallen short of their goals, Thompson wrote in a Forbes article.

"The Obama-era incentives have promoted digitization in healthcare without promoting integration," Thompson wrote. "In some ways, the system is more balkanized now than it used to be, because the cost and complexity of the installed technology deters sharing."

What's more, a RAND report explained that the federal government essentially subsidized "where the industry is" rather than where it should be headed, thereby allowing "hospitals and healthcare providers to use billions to purchase EHRs that did not have the level of connectivity envisioned' by the enabling legislation."

Like Verbeck, Thompson said it's time Congress stepped in to review the DoD's awards process.

"Before committing to the biggest investment in a new health record system in American history," Thompson wrote, "congressional authorizers and appropriators ought to be asking the Pentagon whether it really understands what it is buying."

What's your take? Will the EHR DoD chooses to modernize its system be a boon for the whole industry? Or a bunch of obsolete code a decade from now?

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