Seven years after the Coast Guard’s failed attempt to upgrade its aging EHR system with Epic’s platform, the military agency is still operating with paper records. Now one lawmaker is urging officials to align its medical records with the Department of Defense and the Department of Veterans Affairs.
Rep. Duncan Hunter, R-Calif., pressed Coast Guard officials to adopt Cerner’s EHR platform during a House subcommittee hearing on Tuesday that outlined the numerous failures during a previous five-year $60 million EHR rollout that never came to fruition.
“Why would you not use DOD’s solution now?” Duncan said. “You’re wasting money and time going to look at stuff when it exists right now.”
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Rear Admiral Michael Haycock, the assistant commandant for acquisition and chief acquisition officer for the Coast Guard, said the military outfit is in “close conversation” with the VA and DOD on a weekly basis, adding that a “federal service provider is the solution we’d like to go for.” But he said the agency needs to follow its formal acquisition process that includes the appropriate discipline and oversight and thoroughly explores all options.
“I would highly encourage you guys to do what’s easy, and efficient and effective,” Hunter replied. “Especially when you have really big services with lots of money doing it for you.”
The hearing came on the heels of a Government Accountability report (PDF) released earlier this week that traced the project’s failure to poor management and a lack of oversight. Since it canceled Epic’s contract in 2015, the Coast Guard has been using a “predominantly paper process” according to the GAO.
In written testimony (PDF), David Powner, director of information technology management issues for GAO, said the Coast Guard schedules appointments using Microsoft Outlook, relies on handwritten clinical notes and mails patient records to a new facility or gives it to the patient in a “large sealed envelope.” The vast majority of clinicians working in the Coast Guard’s sickbay said the paper process leads to incomplete records, challenges reading penmanship, difficulty tracking medications and additional time to manage patient records.
Moving forward, Powner recommended that the Coast Guard look at what VA and DOD are doing with EHRs. Last year, VA Secretary David Shulkin said the agency will transition from VistA to a Cerner platform to align with the DOD.
But Shulkin recently put that deal on hold while the agency works out interoperability issues within the contract. Performance work statements released by the agency indicate that data sharing beyond the DOD—particularly with other community providers—is a huge sticking point for the EHR implementation.