Choose an open EHR, DoD is urged
With fewer than five months before the Department of Defense is due to make a decision on its massive $11 billion electronic health record modernization project, a new report from a heavyweight think tank urges it to opt for an open system.
The DoD's $11 billion Healthcare Management Systems Modernization Electronic Health Record program would replace and modernize the existing EHR system, which supports more than 9.7 million beneficiaries, including active duty, retirees and their dependents. It serves patients and clinicians in 2,300 locations around the world.
Vying for the contract are four teams:
- IBM and Epic
- Computer Sciences Corp., partnered with HP and Allscripts
- Cerner, Leidos, Accenture Federal and Intermountain Healthcare
- PwC withGeneral Dynamics Information Technology, DSS Inc., Medsphere, and Google
Medsphere bills its OpenVista EHR, a commercial version developed using VA's open system, as the sole open system in the competition.
[See also: PwC to offer DoD open source EHR.]
On Feb.12, the Center for New American Security released its report, "Reforming the Military Health System," pointing to the dire need for change in how we care for military personnel and their families.
The report takes aim at TRICARE, the DOD’s private sector health benefits program.
"The core problem is that TRICARE’s fee-for-service approach is subject to the same perverse incentive structures that have driven up healthcare costs in the United States by explicitly connecting payment to volume of care, not value of care," write the authors of the report.
The DoD could, and should, take advantage of these changes, to help gain control of healthcare spending. With the upcoming TRICARE procurement, the DoD has a model and framework to bend their costs towards measurable outcomes by aligning with and leveraging the work of other Federal agencies.
In the report, the authors call for an open-source EHR system, value-based care and access to their own medical records for soldiers and veterans.
The report calls for an EHR system that is "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 write. "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."
"We believe that, like in so many other aspects of our society, DOD could play a leadership role," they conclude. "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."
The Center for New American Security describes itself as "an independent, nonpartisan and nonprofit organization that develops strong, pragmatic and principled national security and defense policies." Among its board of directors is retired Marine Corps General John R. Allen, former Sen. Joseph Lieberman and Michele Flournoy, CEO of the organization.
The report is written by retired Army Gen. H. Hugh Shelton, Stephen L. Ondra and Peter L. Levin.
Shelton is a former chairman of the Joint Chiefs of Staff, and is today 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 is today the co-founder and chief executive officer of Amida Technology Solution.
Access the report here.