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Defense Health Agency preps IT infrastructure for EHR

July 16, 2015 (Photo Credit: Mike Morones/Staff)

The Defense Health Agency is making progress in preparing the IT infrastructure that will support the new electronic health record system for the Department of Defense.

The goal is to develop a health IT infrastructure that is centralized, standardized and operational, according to David Bowen, the director of DHA's Health Information Technology Directorate and CIO for the Military Health System.

"So far DHA has made progress on infrastructure preparedness – particularly in the Pacific Northwest Region where we will achieve initial operating capability with the modernized EHR before rolling it out more widely – and efforts are on schedule," Bowen told Federal Times.

The DoD's $11 billion Healthcare Management Systems Modernization (DHMSM) Electronic Health Record program would replace and modernize the existing EHR system, which supports more than 9.7 million beneficiaries, including active duty, retirees and their dependents. The current EHR system serves patients and clinicians in 2,300 locations around the world. The DHMSM contract is expected to be awarded this summer.

DHA is responsible for ensuring that the infrastructure upon which the EHR will run is in place, a massive effort for the agency, Bowen noted. DHA's "tiger team" of engineers, capacity planners and management staff has been on site in the Pacific Northwest working out detailed action plans with site personnel. Among the priorities has been to make sure they fully understand the Military Treatment Facility network bandwidth requirements for wide area, local area, and wireless networks supporting military healthcare operations, Bowen said.

The health IT infrastructure must be standardized and modernized beyond only one application. As a result, the infrastructure will be centralized with secure access and authentication capability to network resources. For instance, the desktop design standardization should serve across the application, desktop and server environments. All the desktops will be standardized so providers and staff will be able to move within the medical facility and have access to their information resources, Bowen noted.

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"This is good IT management and we were moving down this path anyway," he said. "The EHR has caused us to speed it up."

Consolidation savings of $236 million, so far

Launched in October 2013, DHA is a joint, integrated Combat Support Agency that supports medical services for the Army, Navy, and Air Force in both peacetime and wartime.

Each of the armed services IT support teams are being transitioned into DHA, and agency officials are making significant progress in transitioning many of the systems that were previously managed individually by the services into the agency. As part of this transition, DHA officials are making some personnel adjustments and moving people into the appropriate areas of the organization.

By consolidating systems, data centers and resources, DHA was able to report in fiscal 2014 net savings of $236 million, with health IT contributing $39.19 million in savings.

"Our primary goal is to support our medical teams and administrators across the Military Health system with reliable tools to support patient safety, high quality care and access to care when they need it," Bowen said.

DHA has made significant progress in moving email to the Defense Information Systems Agency's Defense Enterprise Email. DEE provides secure cloud-based email for the DoD enterprise designed to increase operational efficiency and facilitate collaboration. So far, email for The National Capital Region (NCR) is fully migrated to DEE. Approximately 25,000 DHA employees, including those at DHA headquarters have transitioned.

DHA has also made progress in consolidating numerous education and training systems into a "one-stop" learning management system, with 23 portals united into a single resource, Bowen said. Joint Knowledge Online also simplifies the capture of training records needed to help ensure individual learning and training requirements are met.

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Additionally, consolidating IT budgets and contracts from across the services will give DHA a greater comprehension of IT expenditures across the enterprise. Transparency of health IT spending is being increased through the establishment of a governance structure, including a Joint Portfolio Board that includes an expenditure approval process, fostering development of a consolidated financial portfolio, Bowen said.

Future technologies

Looking toward the future, the emergence of mobile devices can help boost telehealth capabilities across the globe for service members as well as their family members and other eligible beneficiaries. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.

"As we increase the use of mobile devices, telehealth will provide faster access to information from any location," Bowen said. "Wireless infrastructures will allow providers to use hand-held devices enabling remote patient diagnosis and lab result access."

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