Mixed opinions over the Cerner/DOD EHR deal
Opinions on the new contract between Cerner and the Department of Defense (DoD) range from hopeful optimism to bitter disappointment. Athena Health believes the contract is a step backwards and that the contract should have been given to an internet based EHR system for more interoperability. Many believe that the reasons behind Cerner winning the contract are to do with their open source information attitude compared to main rivals Epic, although the DoDs Frank Kendall stated that the new EHR contract was not to do with interoperability.&nbsp;
As it happens, it appears that the smallish contract awarded to Cerner to replace the Military Health System's anatomic pathology lab technology earlier this month was a hint, after all.

Just weeks later, the Kansas City-based behemoth landed the big prize (although, at an initial value of $4.4 billion, not quite as big as the $11 billion many were first expecting). So what was it that gave Cerner the edge over longtime rival Epic? A perceived commitment to interoperabilty is almost certainly a big reason.

Fair or not, Cerner's reputation in recent years has been one of increasing embrace of openness – at least more open than Epic, which felt compelled this past year to hire a lobbyist to help counter the narrative that it doesn't play well with others.

Whatever the initial motivations for Cerner's founding membership in the CommonWell Health Alliance, for instance, its close work with Allscripts, athenahealth and other vendors makes it hard to argue that it isn't at least trying to enable the freer cross-platform data sharing so essential to better care coordination and population health.

For another example, the company "is a major participant in the DirectTrust network that links over 40,000 health care organizations and nearly a million individual private sector health care professionals via Direct exchange," said David Kibbe, MD, President and CEO of DirectTrust, in a statement supplied to Healthcare IT News. "Cerner has been a very strong proponent of open, standards-based approaches to EHR interoperability."

[Related: Is DoD EHR modernization doomed to failure and obsolescence?]

"Cerner’s demonstration of wide-ranging provider interoperability on multiple, different platforms were the huge differentiator over Epic’s garden-walled methodology to system user data sharing," said Doug Brown, managing partner of Black Book, in another emailed statement on the DoD's decision.

"The message on progressive provider connectivity should also serve as the strategic government directional to the entire EHR sector," he added. "That closed off systems is objectionable for the greater goal of improving national patient quality and access to records anywhere."

In an interview with Healthcare IT News earlier this year, officials from Leidos, the government contractor that will be now working alongside Cerner for the next decade-plus, said commitment to data liquidity would have to be a key capability of the eventual contract winner.

A key component of the Pentagon's RFP was that the system protect the Department of Defense from any eventual "data lock" or "vendor lock" in the years ahead, said Jerry Hogge, deputy group president of Leidos’ Health Solutions.

"This is a 10-year program," he added. "So one of the very few amendments that the government made along the way was to have the vendors demonstrate how their solution would accommodate removing a module or integrating a new one, or adding a new modular capability."

The hope, of course, is that the sheer size of this project – 9.5 million beneficiaries in the DoD system – means it can only have an impact on the rest of the healthcare ecosystem.

The initiative's vast, worldwide scope means "there will be information technology requirements that bleed over into the commercial side of the industry,” Leidos Chief Medical Officer Carl Buising, MD, told Healthcare IT News. “I think what we will see is an advance in the overall information sharing capability and an advance in interoperability."

Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, more or less confirmed that that will be the case in a recent interview with CNBC. The Defense Healthcare Management System Modernization "allows us to pivot toward the future – but also forces others to pivot toward the future," he said.

"We've got to force the private sector to be able to exchange information in a very efficient way, in a very timely way, so we can get better outcomes for those beneficiaries," said Woodson.

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