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CHIME’s Branzell on the DoD-Cerner Deal: Public Perceptions Didn’t Match Reality

July 31, 2015
by Mark Hagland
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CHIME’s Branzell admonishes his colleagues to consider the breadth of the enterprise challenges facing the new consortium now servicing the DoD

Many conversations swirled around the healthcare industry in the hours and days leading up to, and following, the announcement on Wednesday, July 29, that the Department of Defense (DoD) had selected the consortium of the Kansas City-based Cerner Corporation and its partners, the Reston, Va.-based  Leidos, and the Washington, D.C.-based Accenture Federal, to contract with DoD to build an electronic health record (EHR) system that could help both the DoD and Veterans Health Administration serve millions of active military service members, their families, and veterans, across the U.S.

As Healthcare Informatics reported on Wednesday afternoon, “The new contract will cover more than 9.5 million Defense Department beneficiaries and the more than 205,000 care providers that support them. The DoD and the Veterans Administration (VA) are interoperable now, said Undersecretary of Defense for Acquisition, Technology and Logistics Frank Kendall, but this contract ensures it will continue by including future software upgrades.”

The report also noted that “The next step in fielding the system is to test the software to ensure it is secure and does what is needed. The contractor will begin fielding the system at eight locations in the Pacific Northwest covering each of the services late next year. Ultimately, the system will be fielded at more than 1,000 locations worldwide. The cost over 18 years was placed at $11 billion, but new figures suggest the ultimate cost will be below $9 billion, Kendall said.”

The report also noted that, “In recent days, as the health IT industry waited for DoD to announce the winner, reports surfaced questioning if any of the winning teams would be successful in delivering an interoperable EHR system to encompass both active military personnel who receive healthcare through the DoD’s care delivery system, and those veterans who receive care through the VA healthcare system. Nonetheless, according to earlier reports, the DHMSM program calls for an initial capability to be in place in 2016.”

Russ Branzell

Among the many industry leaders watching the happenings on this front has been Russell P. Branzell, president and CEO of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME). Branzell spoke with HCI Editor-in-Chief Mark Hagland about the situation On July 31, two days after the DoD announcement. Below are excerpts from that interview.

This obviously was a huge contract, and one with big potential implications for the EHR sector in healthcare IT. What was your overall reaction to the announcement?

What I’ve been saying consistently, which I think has been lost in all this, is that people are forgetting to understand that this is about so much more than an EMR; it’s about the health and wellness of our military families and our veterans. And I hope in the end, they selected not only an EMR—and  I honestly believe that they could have chosen any one of the three finalist competing teams—but instead, I hope that they deploy a system that benefits the military and military families and veterans in the veterans’ system as well.

What I didn’t like about this, and I shared this with some of the EMR executives, too, is that this came down to the choice of  an EMR, even though this was about so much more than this. But the choice probably came down to how well they were going to transition this and support it long-term.

And I’m not surprised that Leidos got the nod on this, because Leidos is really SAIC, and when I was on the military medical side, we had SAIC at every facility. What I don’t want to lose track of is that this wasn’t about a selection of one EMR over another, but rather, about the best total solution to support military members and families.

Had Epic, which is winning the bulk of new large-scale EHR implementation contracts, won this one, might there have been an implicit policy question to consider?

I don’t know. There’s still so much out there in terms of EMR vendors. People don’t realize how many other vendors are out there. Who has the most implementations across the country? Meditech. And after that, heartland. And many of those smaller community hospitals are right next to military health.

And this is the challenge now that Leidos, Cerner and Accenture have is that they essentially will have to integrate patient flow with every system in the US. I’ve heard that 70-75 percent of care is provided outside the military itself. So as a military member whose primary care provider might be on the base, but they’re going to send me far from the base for my specialty care, it is going to be a monstrous task to be able to deploy not only the solution, but to integrate into the communities of care.