Joint iEHR spending was focused on service contracts

The bulk of spending on the joint EHR proposed by the departments of Defense and Veterans Affairs went to support service contracts in 2012, according to a new report from the Interagency Program Office (IPO), the agency in charge of modernizing the Military Health System's EHR software.

The two agencies pulled the plug on that joint effort in February and the DoD has since been looking to commercial vendors for its new EHR system.

In fiscal year 2012, the IPO spent $329.2 million of its $351.9 million budget on support services contracts, including program management support and Agile development, the report states.

It filled 141 of 236 open positions with permanent federal civilian workers or existing DoD employees, and employed 171 contractors.

It reported "substantial" progress on its two major projects--the iEHR and the Virtual Lifetime Electronic Record (VLER), including developing an incremental plan for iEHR deployment and the overall schedule, design and costs of the program. 

"In a dynamic and ongoing process of developing a single, integrated EHR system for the Departments, IPO  program, technical, and clinical informatics teams fully defined andscheduled joint Departments capabilities and processes for the departments' iEHR," the report says. "To meet challenges of managing the sizable and complex task of modernizing the departments' legacy health IT systems the IPO focused on building and maturing the IPO, designing the iEHR solution, exercising  governance, reducing risk to the  iEHR  program,  building iEHR technical infrastructure, and defining clinical and technical requirements."

It says it over overcame interagency coordination issues by physically placing senior staff program managers together at the IOP.

Among its challenges, it says, were combining the two agencies' business operations and policies into defined, standardized joint clinical workflows and standardizing data for the iEHR user.

A lead software designer for VistA, the VA's system, has criticized Secretary of Defense Chuck Hagel for not taking a patient-centric approach and said the DoD is "paving a road to a hellish destination" by looking to outside vendors for its EHR needs.

Meanwhile, Congress is attempting to light a fire under the two agencies by introducing legislation that would set strict timelines for seamless patient data sharing.

To learn more:
- find the report (.pdf)