Seismic shifts in defense healthcare policy are complicating the government’s plans for portable and comprehensive electronic patient health records, with a rift forming between the Department of Defense (DOD) and the Veterans Administration (VA) over the right way to move forward.
Cruise on over to the Interagency Program Office’s web site, in fact, and you’ll encounter an interesting greeting:
The Interagency Program Office (IPO) site is no longer available. Additional information regarding the future of the IPO will be forthcoming. Thank you.
Sounds foreboding. The Interagency Program Office is a joint DOD/VA operation established to oversee, as the name suggests, the initiative of sharing health data between the departments, otherwise known as iEHR.
Signs now point to the IPO essentially being mothballed until further notice, with only lip service paid to its continued relevance.
[Related: DoD gives glimpse of imminent EHR expecations.]
Of note is that in addition to DOD dismantling the Military Health System earlier this year, leading to the creation of the Defense Health Agency (DHA) formally established October 1, the Department recently created the DOD Healthcare Management Systems Program Executive Office (PEO DHMS), whose main purposes are overseeing the replacement of the military’s legacy electronic health record system and adding another layer of IPO oversight, further weakening that office. This PEO lies outside of DHA’s purview, answering directly to the Pentagon’s acquisition czar. Given the high profile nature of the iEHR program, that will likely remain the case.
Defense health officials hope that DHAs shared services model, which merges functions such as Health IT under a common roof, will enable the military to stem increased healthcare costs (the Department spends as much on salaries as it does on health benefits). DHA officials estimate the new agency can save over $250 million in its first year through portfolio consolidation.
Despite this move to streamline operations and improve healthcare services, the changes spell an uncertain future for the integrated electronic health record (iEHR). The goal of the iEHR program (originally known as the “EHR Way Ahead Program”) was to create a comprehensive electronic health record, shared by the DOD and VA.
In February, VA and DOD ostensibly went separate ways, DOD choosing instead to replace its own legacy healthcare IT system. Technology challenges and skyrocketing costs were blamed for the failure of the joint interoperable iEHR effort. Since then, there have been conflicting messages on the status of the iEHR – and, by extension, the IPO.
By May, Federal Chief Information Officer Steven VanRoekel seemed resigned to having each department develop its own systems, then trying to figure out a way to make the two systems talk. In late October, the Pentagon hosted a week of vendor demonstrations for a replacement to its electronic health record, indicating that DOD is indeed moving in its own direction. Furthermore, speakers at a recent TechAmerica conference pronounced the IPO effort as all but dead, revealing that much of the IPO funding on the VA side was being reprogrammed to the Veterans Health Information Systems and Technology Architecture (VistA), which is that agency’s native electronic health record program.
And the 2014 Military Construction and Veterans Affairs Appropriations Bill gives Congress power to withhold all but 25 percent of funding for iEHR until the DOD and VA can show progress. Perhaps that’s driving the Pentagon’s recent award via the IPO to incumbent Systems Made Simple to continue providing ”systems integration and engineering support for executing the iEHR initiative,” which on the surface seems to the support the notion that the iEHR effort still has some momentum.
The VA, for its part, is hoping the Pentagon will adopt its legacy system, particularly after planned upgrades. This would theoretically make interoperability much easier. So far though, the Pentagon appears content with pursuing alternate, commercial alternatives.
So, what’s the fate of iEHR? Despite a push from both Congress and the VA to jumpstart the iEHR effort, all parties seemed resign to waiting until the Pentagon replaces its legacy systems before taking on any further work on an interoperable system. One can only hope — for the sake of our military men and women — that the replacement effort moves forward quickly.
Lloyd McCoy is a market intelligence consultant with immixGroup, which helps technology companies do business with the government. He can be reached at Lloyd_mccoy@immixgroup.com.
Related articles:
ONC reveals Blue Button codeathon winners
