Boost to VA EHR in the works

DoD moves forward to acquire commercial EHR
By Bernie Monegain
08:29 AM
Independence day 2014 and work is under way on military's, veterans' EHRs.

The Department of Veterans Affairs has awarded a three-year, $162 million contract for upgrades to its VistA electronic health record. The announcement comes just as government officials assert in a news release Thursday that the multi-billion dollar acquisition to modernize the Department of Defense electronic health record is on track.

The goal, according to DoD, is to to create interoperability and healthcare information sharing among DoD, VA and private healthcare providers, and to have initial operating capability by 2016.

[See also: DoD to go to market for its EHR.]

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A report Thursday from the American Forces Press Service, notes that Christopher Miller, executive officer for the Defense Healthcare Management Systems Modernization and Integrated Electronic Health Records Program organization, is finalizing the draft request for procurement for an EHR. There have been three draft requests for proposals, and the final RFP is set for release later this fiscal year -- in the third quarter of 2014, according to Miller.

EHR vendor Epic and IBM announced last month they would partner to compete for the DoD contract. A few days later a team led by CSC, with Allscripts and HP, announced it, too, would bid on the project.

The VA's care for veterans and its EHR system VistA have been in the spotlight since a May report from the VA's independent Inspector General exposed a scandal that involved cover-ups of treatment delays that resulted in deaths.

VistA, once credited for supporting the VA in providing top care for veterans, has more recently been criticized for lacking in interoperability.

Even as officials work to replace the DoD system, ASM Research, an Accenture Federal Services Company, announced Thursday it was awarded a contract to shore up the VA's existing VistA EHR.

The VistA core project work is designed to strengthen and expand veteran healthcare services, according to an ASM Research news release. Work under the contract enables greater interoperability of systems and healthcare records and will meet the highest security standards, according to ASM Research.

ASM also will update VistA's computerized patient record system providing a modern, Web-based access to patient records. CPRS is a critical component of VistA that provides clinicians, managers, support staff and researchers an integrated patient record management system that provides a single interface for physicians to manage patient care and records.

"VistA Enterprise Core Services will modernize the VistA workflow and information access throughout the continuum of patient care for our veterans," said Jim Traficant, president of ASM Research and a managing director at Accenture Federal Services, in a press statement.

Work under the contract also will help improve data sharing across the VA, including care transitions and implementation of standards of care. ASM will deliver technical architecture, clinical analysis, software development, engineering management and training to support VistA modernization. This work will help the VA build the next level of patient care capabilities within VistA.

"The VA's ability to improve data interoperability will have a dramatic effect on the VA's provision of the quality of care, patient safety and healthcare outcomes," said John Fraser, ASM Research executive vice president and COO.

As Edmund Billings, MD, sees it, the VA's recent troubles should be attributed to poor management, rather than failed technology. Billings is CMIO of Medsphere Systems Corporation, the developer of the OpenVista electronic health record, a commercial EHR based on the VA's open system.

"According to a May 31 NY Times article, veterans themselves blame the bureaucracy and praise the quality of care they receive once they are through the doors. Indeed, their complaints -- repeated canceled appointments, un-returned calls, lengthy waits for appointments and rapid turnover in physicians -- all fall under the management heading," Billings writes in a July 1 blog.

[See also: VistA and Epic: A tale of two systems.]

"New VA leadership must revamp the local and/or regional bureaucracy to make it transparent and open. Congress must increase funding for VA healthcare services and increase the number of available physician slots. And VistA must endure as part of the solution, as it is not part of the problem," he concludes.

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