An RFP for a contract to modernize the DoD's electronic health records is just weeks away. (Getty Images/iStockphoto)
Top managers of the Defense Department’s estimated $11 billion healthcare modernization program seek a single integrated electronic health records system that will be interoperable with external health networks and require no customization for the various armed services.
Anticipating the release—expected in the next three months—of the final request for proposals, more than 400 vendor representatives attended an Industry Day on June 25 to learn more about DoD’s requirements for its planned 10-year Defense Healthcare Management System Modernization (DHMSM) contract.
Program managers said the system must be able to exchange data with the Veterans Affairs Department, other federal agencies and private TRICARE providers. More than 60 percent of care for the population occurs outside DoD.
Replacing antiquated records systems will give DoD health care practitioners access to medical and dental records for 9.6 million patients worldwide wherever and whenever needed. That includes more than 1,000 military treatment facilities in the field, aboard ships and planes, in base hospitals and clinics, and in communities.
Service members "deserve the most up-to-date and modern system we can give them," said DHMSM Program Executive Officer Chris Miller. The government must ensure that a patient’s data "flows with them"—a concept known as portability—when they transfer to the VA for care, Miller said.
However, the systems that currently manage health records have reached the end of their service life, Miller said. The Defense Health Agency plans to award the new contract in the third quarter of fiscal 2015. Miller said there still is no accurate estimate of the contract’s value at this point. Deployment would start in 2016 in the Pacific Northwest.
The program seeks to acquire a service provider/integrator with an off-the-shelf EHR system. The goals are enabling clinicians to provide better patient care through improved decision making, better service and cost savings.
Miller stressed that the government wants to buy existing software that can be set up with minor configuration adjustments.
"We're emphasizing we are not going to customize this for every service," Miller said. "To be agile and responsive, we have to minimize customization."
The event, to facilitate exchange between the government and prospective contractors, was one in a series to help DHA as it develops its requirements. The third draft RFP, released in June, substantially reflects what will be in the final RFP, the program manager, Navy Capt. John Windom, told industry representatives. "We're nearly done," Windom said. Comments and questions about the third draft are due July 2.
Miller acknowledged the final RFP will not be perfect. "There will probably be risk and uncertainty in this RFP," he said. Windom said the government has no interest in withholding information because full disclosure leads to better pricing, and warned contractors "assumptions won't be tolerated in your proposal." "Price the risk accordingly," Windom said.
Program officials also emphasized that technology is just one part of the solution, and that training people and change management are equally, if not more, important to success. "What we're asking for is not just a shiny piece of software from a major provider," Miller said.
Attendee Nancy Adams, a program manager at Hawaii Resource Group, a government services and IT company based in Honolulu, predicted the final RFP would read more like a statement of objectives, requiring respondents to convert it into a detailed proposal and statement of work.
"I believe that a lot of the vendors that come to these sorts of things and have been watching the DHMSM draft releases were hoping for, or were expecting very detailed specifications and I don't think that's going to happen," said Adams, whose company supports the Joint Legacy Viewer, an interim system that displays DoD and VA information on one screen. "The devil's in the details," she said.
Attendee Scott Campbell, federal account manager at InterSystems, a global software provider that specializes in interoperability, said he appreciates that program officials have been willing to meet one-on-one with industry representatives. "It is the most transparent solicitation that I've seen come out of military health in my 10 years," Campbell said.
About four to six teams of companies that have partnered are expected to bid on the final RFP, Miller said. IBM announced earlier this month that it has teamed with EHR provider Epic. Health systems integrator CSC will lead a team that includes Allscripts and HP, both of which have health IT experience.
The government has tried and will continue to do everything it can to avoid a bid protest, such as run an interactive process, document every decision and be as open as possible on how it built the source selection architecture, Miller said. But he acknowledged a "high probability" of a protest. "I'm a realist," Miller said. "From a scheduling perspective, we kind of factor that in."