DoD to replace EMR after $2B upgrade only a mild success

Federal agencies that have their own health systems have been busy pondering the future of their EMRs, and some actually have taken steps forward recently.

Of particular note, the Department of Defense has all but decided to replace its longstanding AHLTA EMR, despite spending $2 billion to upgrade the system since 1997. A Government Accountability Office report says that the upgrades have only been partially successful, but cautions that a new system could suffer greater failures if the Military Health System does not study the lessons of the previous upgrades.

"DoD has initiated efforts to bring its processes into alignment with industry best practices," the GAO report reads, according to Federal Computer Week. "However, it has not carried out a planned independent evaluation to ensure it has made these improvements. Until it ensures that these weaknesses are addressed, DoD risks undermining the success of further efforts to acquire [EMR] capabilities."

The DoD has requested $302 million in its 2011 budget for a replacement system, dubbed Way Ahead, and is working on an analysis of possible strategies, set for completion by December, FCW reports. For that analysis, the GAO recommends that the Military Health System: develop and regularly update a comprehensive project plan that considers scope, cost, schedule and risks involved; develop a systems engineering plan; and create a strategy for improving user satisfaction.

Over at the Department of Veterans Affairs, which itself had conducted a comprehensive review of its health IT systems and shifted some of its priorities, a new pharmacy system is up and running at a South Carolina VA hospital and will be at four other hospitals soon, VA CIO Roger Baker told a Senate committee last week, according to Government Health IT. The VA reportedly met more than 80 percent of its major IT milestones for fiscal year 2010, which ended Sept. 30, up from 30 percent a year earlier.

Among the VA's top priorities for the future is finding an open-source means of updating its aging Veterans Health Information Systems and Technology Architecture (VistA) EMR that was written in outdated MUMPS programming code.

In other news, the U.S. Coast Guard has selected Epic Systems to build a $14 million EMR system that will meet federal "meaningful use" requirements, InformationWeek reports.

To learn more:
- see this Federal Computer Week story about the GAO report
- download the GAO report itself (.pdf)
- read this FCW follow-up about an AHLTA replacement
- have a look at this Government Health IT article about the VA pharmacy system
- check out this InformationWeek story on the Coast Guard contract