The Department of Defense electronic health records procurement valued at up to $11 billion came under fire during a May 5 Senate committee hearing following concerns that the EHR won’t interoperate with the Department of Veterans Affairs system.
Senator Bill Cassidy (R-La.), M.D., put National Coordinator for Health IT Karen DeSalvo, M.D., in the hot seat to answer for DoD acquisition officials, asking her if DoD-VA interoperability is being addressed. “My fear is that the very vendors who are blocking data are the ones bidding,” exclaimed Cassidy.
DeSalvo testified before the Senate Health, Education, Labor, and Pensions Committee that “one of the most important things is to move away from proprietary standards which are getting in the way of the systems being able to talk” to one another. She assured Cassidy that “vendors will have to agree to use the standards that the Department of Defense wants to use, which are the ones that ONC has published.” However, DeSalvo cautioned that “the VA and DoD is a separate issue because they have a different kind of technology but yes, sir, the goal is that it becomes not only exchange but interoperability.”
Cassidy pressed that interoperability might be the goal, yet he expressed his skepticism about the likelihood of it in fact being achieved. DeSalvo replied that “what the VA and DoD have done now is they have found a solution to exchange information,” and “if you’re at the bedside with the patient you can see the records from the VA and DoD—so they’ve taken that first step.” She revealed that the “integrating of the data requires having the same core data elements, so there’s a technology issue which is solvable.” DeSalvo added that there’s also a “policy and culture issue” which she offered is “honestly a harder one” to solve.
In 2013, DOD and VA cancelled plans to jointly develop an integrated EHR system due to cost and schedule challenges, and instead decided to pursue separate efforts. But, as Cassidy referenced in his questioning of DeSalvo, a July 2014 audit by the Government Accountability Office found that DoD and VA are not making a lot of progress on their plans to modernize their respective EHRs, including provisions for interoperability between the two systems.
The senator pointedly asked: “Is it part of the initial [DoD request for proposals] that [vendors] cannot block and that the VA has to be able to share?” DeSalvo answered in the affirmative that “yes, that is the intention of the DoD” but stopped short of guaranteeing it, deferring to DoD.
“The DoD’s acquisition of a new electronic health record is one of the most important things that’s going to happen on the health IT landscape, and we are intimately involved in that,” added DeSalvo. “The Department of Defense, for example, has embedded staff with us at ONC to see that we’re communicating.”
DoD’s goal is to begin deployment of the new system by the end of fiscal 2016. Under the planned EHR system, medical records would seamlessly move between DoD organizations and private healthcare practitioners, providing a comprehensive real-time health record for service members and their families and beneficiaries. The selection of an EHR system is expected later this year.
Courtesy of Information Management's sister brand, HealthData Management.
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