After several draft versions, a request for proposal for the Defense Department's highly-anticipated electronic health record is taking shape. Draft solicitations for the DoD's Healthcare Management System Modernization, or DHMSM, have been updated several times since DoD issued its first acquisition draft document in January.
Electronic health record interoperability between the Defense and Veterans Affairs departments has been a long time coming, but an interagency program office is making progress, a DoD official told lawmakers during an April 9 hearing.
House appropriators propose a $3.87 billion budget for information and technology systems at the Veterans Affairs Department. That amount, released April 2 in a draft (pdf) of the fiscal 2015 Military Construction and Veterans Affairs Appropriations bill, includes $344 million for the department's electronic health record.
The department of Defense and Veterans Affairs continue to pursue a project known as the iEHR, which is falling behind schedule, finds the Government Accountability Office.
The Defense Department may select the Veterans Affairs Department's electronic health record system when it procures its EHR, VA Secretary Eric Shinseki said at a House hearing March 13. Defense Secretary Chuck Hagel "assured me we're going to be in the competition, and so my work for the next two years is just to get us as competitive as anybody else," Shinseki told the House Veterans' Affairs Committee.
The White House fiscal 2015 budget request designates $3.9 billion for the Office of Information and Technology and the Veterans Affairs Department. In nominal terms, that's a $2 billion increased from the estimated current year amount of $3.7 billion.
The departments of Defense and Veterans Affairs lack credibility when they say their separate pursuit of electronic health record systems modernization is cheaper than a single EHR would have been, says the Government Accountability Office. A Feb. 27 report from the legislative watchdog also shows how promises of close cooperation in health IT the two departments made during the termination of a program to develop a joint system have been significantly undermined.
The DoD has signaled its intent to buy a commercial EHR to replace its legacy systems since it and the Veterans Affairs Department canceled in February 2013 (citing cost reasons) an effort that would have resulted in a joint EHR running in both military and veterans medical systems.
Since the February 2013 cancelation by the VA and Defense Department of a planned joint integrated EHR – the iEHR – the VA has faced the problem of modernizing its legacy EHR, officially known as the Veterans Health Information Systems and Technology Architecture, but referred to daily as VistA. Industry insiders describe VistA Evolution as preparatory work for what may be future procurements of specific EHR modules, such as those for pharmacy prescriptions or lab results.
Veterans Affairs Department information technology appropriations for the current fiscal year are set to reach $3.7 billion, an amount that exceeds the departmental request of $3.68 billion.