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;
When Defense Department officials briefed reporters prior to announcing that the Cerner, Leidos and Accenture team won its EHR modernization contract, they were adamant that so much speculation about the DoD’s ability to share patient information with the Department of Veterans Affairs had been unfounded.

"There is not a big interoperability problem with the VA and DoD today," said Frank Kendall, DoD Under Secretary for Acquisition, Technology and Logistics. "It’s a big misconception out there that this software system we’re buying is about interoperability."

Speculation about the inability of DoD and VA to swap records invariably stems from the sprawling Integrated Electronic Health Record, formerly known as iEHR, that the two departments embarked on together before the project wound up mired in politics and finger pointing.

VA publicly urged DoD to use its long-standing VistA proprietary EHR as a replacement for the DoD’s aging AHLTA – in fact, a suggestion DoD said it considered before opting instead for a commercial off-the-shelf option. That effectively triggered the long request for proposals that drew to a close late Wednesday.

[Innovation Pulse: Hardest part for FHIR interoperability lies ahead.]

DoD Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, explained that choosing a COTS EHR enables DoD to tap into private sector innovation and Kendall explained that the department’s own "extensive analysis" determined it would be cheaper than tailoring VistA to the DoD’s needs.

The DoD has been working extensively with both VA and the Office of the National Coordinator for Health IT on interoperability and standards, according to Chris Miller, program executive officer for DOD's Healthcare Management Systems Modernization and Integrated Electronic Health Records.

Miller added that the ability to interoperate with both VA and private providers was among the list of requirements DoD had in making its selection because of how frequently it exchanges patient records with VA.

"We share more info between VA and DoD than any two other large institutions today," Miller said. "Interoperability is not something you just go buy one day and you have it. We are continuing to look at ways to build upon the interoperability we have with the VA."

Reiterating that DoD wants to build on the work with VA and private providers, Kendall said the departments trade more than a million pieces of information every day.

"Interoperability is always about degrees," Kendall said. "You can always get better at it."

Related articles:

Is DoD EHR modernization destined to fail?

EHR go-live gone wrong

DoD EHR modernization set to rock marketplace