How the Coast Guard’s ugly, Epic EHR break-up played out
What began as a straightforward software contract with Epic resulted this week in the U.S. Coast Guard starting its entire EHR acquisition process over some seven years after it began.
EHR implementations are notorious budget-busters often fraught with missed deadlines and other unforeseen complications, but for an organization to abandon the project altogether and embark on a new beginning is uncommon.
Indeed, this occurrence includes some finger-pointing from both sides. So what exactly went wrong?
October 5, 2010
The Coast Guard awarded Epic a 5-year $14 million contract for what it said at the time would be a state of the art electronic health record platform with modules for dental, laboratory, patient portal, pharmacy, and radiology. Epic was also contracted to offer training, testing, backup services and help desk support.
April 22, 2016
Citing significant risks and various uncovered irregularities, the Coast Guard pulled out of its contract with Epic.
"The decision was driven by concerns about the project's ability to deliver a viable product in a reasonable period of time and at a reasonable cost,” Lieutenant Commander Dave French, the Coast Guard's chief of media relations said then. “As a result of the analysis that led to the discontinuation of the project, various irregularities were uncovered, which are currently being reviewed."
At that point, the Coast Guard returned to using paper-based records for patient care.
French also said the Coast Guard would restart its EHR search.
April 26, 2016
After the Coast Guard said it was closing its Epic contracts and setting invoices, the EHR maker posted to its website a reaction piece titled Epic and the U.S. Coast Guard: the Facts where the company said the storage area network housing the software project was “inexplicably corrupted with no root cause,” and twice deleted by employees of Leidos, the Coast Guard’s partner tech support partner for the project, immediately prior to go-live. Epic also said there were hardware procurement delays, a change to the datacenter, re-contracting issues and a federal investigation, all of which pushed back the project timelines.
“We did everything in our power to complete the install. We fulfilled the terms of the agreement and provided the software and implementation services to meet the Epic obligations of the project,” Epic said. “The software was ready to go live.”
April 23, 2017
The Coast Guard’s new beginning emerged in the form of requests for information the Coast Guard posted to FedBizOpps.gov to understand what products are on the market today including cloud-based and on-premise options.
It’s early in the process. RFIs, in fact, are really meant as an information gathering step so the agency can get a sense of what a state of the art EHR looks like today, which capabilities vendors can either address now or build into their products in short-order and identify features the Coast Guard might like but are not yet realistic.
A look into the RFIs found that the agency is seeking information on EHR functions concerning information interoperability, population health, surveillance features, mental health, patient safety, as well privacy and security functions, among others.
And, of course, it needs to be interoperable with the U.S. Departments of Veterans Affairs and Defense — which already has some industry insiders speculating that the Coast Guard could pick Cerner for its next EHR.