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DoD and Tech Firms Face Daunting Health-IT Challenge

By John K. Higgins
Sep 22, 2014 5:00 AM PT

The U.S. government is about to embark on a major information technology program dealing with personal health records. The program is being launched by the U.S. Department of Defense, which issued a request for proposals to health IT providers late last month.

DoD and Tech Firms Face Daunting Health-IT Challenge

The initiative, known as the "Defense Health Care Management Systems Modernization program," or DHMSM, is expected to support medical readiness for DoD's military personnel and support the department's current population of more than 9.6 million beneficiaries and more than 153,000 Military Health System personnel.

Through the department's electronic health record modernization initiative, the DoD Healthcare Management System (DHMS) program executive office also will continue to improve health data-sharing capabilities with the Department of Veterans Affairs and private sector healthcare providers. That will allow clinician and beneficiary access to information whenever and wherever it's needed.

Civilian healthcare organizations provide nearly 60 percent of healthcare for service members and their families, according to DoD.

IT Consortiums Will Compete

Estimates of the cost of the program have been reported as high as US$11 billion.

Although "that figure embraces a broader life cycle related to military health IT," said project manager Chris Miller, "we expect the DHMSM will be a multibillion project." said.

The RFP contemplates a performance period that could extend for 10 years.

A consortium of companies led by PricewaterhouseCoopers earlier this month became the latest group to publicly announce it would submit a proposal to DoD for the contract. Four teams have been formed to compete for the project:

  • PwC, General Dynamics, DSS, and MedSphere;
  • IBM, Epic and Impact Advisors;
  • Leidos, Cerner and Accenture;
  • CSC, Allscripts and HP.

The task for the eventual contractor, as well as for DoD, will be daunting, and likely will bear watching for any possible impacts on other government or private sector healthcare IT programs.

"DoD is taking on this challenge at an opportune time. The private sector has made enormous strides over the past six years in health information technology systems and interoperability, so there is much that DoD can learn from what's already taken place," said Jennifer Covich Bordenick, CEO of the eHealth Initiative.

"On the other hand, given the sheer size and scope of this integration effort, you can be sure that the private sector will keep a close watch on what DoD does as well," she told the E-Commerce Times.

"On one hand, we've seen how the deployment of a federal electronic health record can send ripples throughout the private healthcare space," Lloyd McCoy, a consultant with immixGroup, told the E-Commerce Times.

The pioneering work of the VA for an EHR system known as "ViStA" and a related health data imaging program, HL7, "led to the adoption of HL7 and ViStA clones cropping up nationwide," he noted.

"Also, a key part of what DoD is trying to accomplish with the new EHR is to improve interoperability between the DoD and private hospitals. We can surmise that success there, coupled with HiTECH Act incentives, could lead to interoperability opportunities catching on among private sector health providers," McCoy said.

Part of the 2009 Stimulus Bill, the HiTECH Act provided federal incentives for the adoption of health records technology, primarily patient medical records. In fact, DoD noted that its program protocols will seek to be aligned not only with those of the VA, but also with the Office of the National Coordinator at the Department of Health and Human Services, which oversees the HiTech program.

A Formidable IT Objective

There will be challenges in pursuing DoD's objectives, McCoy noted.

"The other side of the coin relates to the costs of upgrading or replacing existing EHRs and the sheer number of closed systems out there that has hampered the spread of EHRs and interoperability among existing systems in the private sector. A new EHR within the DoD doesn't really address these challenges," he said.

"The DoD's electronic health record program is a large and extremely complex undertaking. There are a number of different vendors, players, technologies, organizations and politics involved, resulting in tremendous barriers to overcome," Bordenick said.

"That doesn't mean it is impossible to execute DHMSM successfully -- but it will be a difficult feat. We have great success stories of similar programs in the private sector that can be used as case studies for the public sector," she added.

"At the very least, this contract puts EHRs in the spotlight. If the rollout goes off without a hitch and there's measurable return on investment, then I think you could see the market improving in the private sector for EHRs," McCoy said.

The Federal Buzz: Dell Lands Contract; NIST Cyber Call

CDC Selects Dell: The U.S. Centers for Disease Control has selected Dell Services to provide the agency with comprehensive IT infrastructure, application and user support services.

Under a five-year, Information Technology Infrastructure Support Services contract, Dell will extend its 11-year relationship with CDC. The contract is valued at more than $120 million. Dell will support CDC with infrastructure services that support CDC's vision of IT serving an enabling role in achieving agency goals.

"We have had a longstanding, successful relationship with the CDC that has allowed us to demonstrate firsthand the merits of automated, streamlined processes; rapid deployment of customized applications; centralized service desks; high network availability; and remote desktop support," said George Newstrom, vice president and general manager, Dell Services Federal Government.

"At this point, this contract does not include public or private cloud implementation, although we always maintain a commitment to helping our customers meet their specific IT needs," he told the E-Commerce Times.

The scale of the contract mission will provide opportunities for other firms to work with Dell.

"We have a number of subcontractors we will be working with as a part of this contract," Newstrom said.

NIST Seeks Cybersecurity Views: The National Institute of Standards and Technology is seeking presentations for a one-day symposium to explore cybersecurity needed for direct digital manufacturing (DDM). The deadline for submissions is Oct. 31 for the scheduled Feb. 3, 2015, meeting.

Among topics of interest to NIST: 1) how the use of DDM supports mission or business objectives; 2) interfaces between cyber and physical mechanisms; and 3) the types of security requirements that might be needed that are unique to DDM as opposed to strictly cyber or physical systems.

Abstracts should be sent to celia.paulsen@nist.gov and submitted in Microsoft Word or a compatible format. Selected submitters will be chosen, based upon the extended abstracts submitted, to give a presentation at the symposium.


John K. Higgins is a career business writer, with broad experience for a major publisher in a wide range of topics including energy, finance, environment and government policy. In his current freelance role, he reports mainly on government information technology issues for ECT News Network.


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