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Wednesday, July 29, 2015

Cerner wins Pentagon EHR contract - FierceEMR

By Dan Bowman

"A team led by Kansas City, Missouri-based Cerner Corp. has won the highly coveted contract to implement the electronic health record system for the Department of Defense.  This was a competitive acquisition, with six offers received. 

The Defense Healthcare Management System Modernization contract is worth $4.3 billion for its first phase of two years. There are two additional three-year option periods as well as a potential two-year award term. The system will be installed at 55 hospitals nationwide. Estimates for the contract ran as high as $11 billion, but the overall estimated value of the contract is roughly $9 billion. 

Cerner, which teamed with Leidos and Accenture Federal,beat out two other finalists: Epic, with IBM and Impact Advisors, and Allscripts, which teamed with Computer Sciences Corp. and Hewlett Packard (HP).

Another team eliminated from contention for the contract earlier this year was PwC, which was bidding with Google, MedicaSoft, General Dynamics Technology, DSS, Inc. and Medsphere. That team was using code from the Department of Veterans Affairs' VistA EHR.

                                                        Pentagon 1941

                                                       Pentagon Today

The only other Government EHR that rivals the size of this project is that of the Veteran's Administration, VISTA-CPRS system which has been in existence for over 20 years. This system's original  design dates back two decades and has evolved from a patchwork of upgrades.

The new military grade EHR will be based upon known features of a giant nationwide EHR system. It is difficult to compare the military EHR with that of the recent fiasco of the National Health Information Exchange at That system was not an out of the box ready to go. It required development from the get go.  Nevertheless Cerner and it's partners will be under the gun to produce value for the money. The partnership in itself is interesting.

"In May 2014, the DoD awarded Leidos a $70.7 million sole source bridge contract to support its current EHR system for 11 months. Leidos, previously known as Science Applications International Corporation (SAIC), managed clinician order entries for the Pentagon via a $1 billion Composite Health Care System contract in 1988; it won additional contracts in 2009 and 2011 to continue its work, according to Nextgov

"Leidos, Inc., Reston, Virginia was awarded  indefinite-delivery/indefinite-quantity contract, with firm-fixed-price, cost-plus-fixed-fee, cost-plus-incentive fee, and fixed-price incentive pricing arrangements, for the Defense Healthcare Management System Modernization program. As a service provider integrator, the contractor will provide an electronic health record off-the-shelf solution, integration activities and deployment across the Military Health System  This was a competitive acquisition, with six offers received. The Space and Naval Warfare Systems Command, San Diego, California, is the contracting activity (N00039-15-D-0044)."

As usual the government had a circuitous contracting pathway, open to  poor communications from the RFP to the implementation and payment to a vendor.

Cerner is known for it's time tested software and it's rollout over the past five years as health information systems and EHRs were folded into the American Health  System.  Epic has also demonstrated it's compliance with meaningful use. a requirement for certification by CMS and HHS. Most providers rank interoperability high on the required list, while Meaningful Use is still open to doubts. It seems to be more of an analysts tool for measuring outcomes, and studying quality improvement.

"The DoD's decision to purchase an off-the-shelf EHR product is one that has been met with a degree of skepticism, with concerns looming about potential interoperability issues with systems from other hospitals. For instance, at a Senate hearing in May, National Coordinator for Health IT Karen DeSalvo was askedwhy the Pentagon would choose to purchase a system from a team led by a company already identified by the federal government to lack interoperability

And in March, Loren Thompson, COO at the nonprofit Lexington Institute, criticized the approach of buying an EHR for being "antiquated." "Before committing to the biggest investment in a new health record system in American history, congressional authorizers and appropriators ought to be asking the Pentagon whether it really understands what it is buying," he wrote.

The Pentagon released a draft request for proposals on Jan. 29, 2014."

sources: Wikipedia, DOD, Veterans Affairs, FierceHealth IT, 

Cerner wins Pentagon EHR contract - FierceEMR

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