Published: May 12, 2013
After five years and an estimated $1 billion spent trying to build a single integrated electronic health record system with the Department of Veterans Affairs, defense health officials have been taken off the project, sources confirm.
Wielding the hook was Defense Secretary Chuck Hagel, who signaled disappointment with his management team to a House panel this month, saying he halted a solicitation for bids from commercial electronic record designers because 'I didn't think we knew what the hell we were doing. '
A congressional source confirmed that DOD oversight for developing an interoperable electronic health records is now under Frank Kendall, under secretary of defense for acquisition, technology and logistics.
The shift was first reported Monday by the news website NextGov.
A cloud of confusion descended on the effort to create a single e-record system after an awkward joint announcement in February by departing Defense Secretary Leon Panetta and VA Secretary Eric Shinseki. Panetta suggested development of a single system had grown unaffordable and some 'quick wins ' were needed to show progress on seamless transfer of electronic medical files of veterans moving from military to VA care.
Rather than build a customized system 'from scratch, ' Panetta said, the VA would keep but improve its popular record system, Vista, and electronic military health data would gain interoperability with VA by deploying an existing commercial software solution 'as quickly as possible. '
By summer, he said, the agencies would field a pilot program that would allow clinicians to share VA and DOD medical data at seven joint rehabilitation and poly-trauma centers treating veterans with the most serious wounds. These facilities would have interoperable records by the end of July, Panetta promised.
What the two leaders actually were announcing, charged the chairmen and ranking members of the veterans affairs committees, was their failure to agree on a single record system after years of work and public promises.
They said this compromise wasn't what Congress directed in 2008 nor was it what Barrack Obama had promised campaigning for president and in 2009 when announcing a joint Pentagon and VA effort to build a single virtual lifetime electronic record for veterans from enlistment to their death in old age.
Yet for weeks after the February announcement, VA and Defense Department leaders continued to insist the compromise was what had been promised.
Key lawmakers, including Sen. Patty Murray, D-Wash., now Senate budget committee chairman, and Rep. Jeff Miller, R-Fla., House veterans affairs committee chairman, didn't buy that claim nor, it turns out, did Hagel after he was briefed on the course change.
Architects of the compromise were Jonathan Woodson, assistant secretary of defense for health affairs, and Beth McGrath, deputy chief management officer for the department.
Their plan to buy proprietary health records software from industry, however, was labeled as expensive and shortsighted by other technical experts inside the Pentagon.
The director of operational test and evaluation for the Defense Department, J. Michael Gilmore, told Deputy Defense Secretary Ashton Carter in a March 28 memo that the 'current approach is manifestly inconsistent with the president's open standards agenda for electronic health records. '
While Obama wanted 'a broad spectrum of government, industry and academic participants ' involved in pursuit of an open standards record system, which would be less costly and easier to achieve, Gilmore charged that the military's actions throughout Obama's first term had gone against the president's agenda.
'The department's past and current desire is to completely replace its healthcare information technology package - Armed Forces Health Longitudinal Technology Application - with an existing commercial healthcare management package, ' Gilmore said.
This resistance to an open standards agenda, he continued, 'appears to be founded largely on an incorrect assumption '. But an open standards agenda 'has nothing whatsoever to do with the department using Vista. '