Leidos team touts interoperability in military EHR bid

Time is running out for vendors to submit bids on the planned $11 billion, 10-year contract to deliver an electronic health records system to the Defense Department. The DOD Healthcare Management System Modernization (DHMSM -- pronounced "dim sum") is an ambitious plan to transform the delivery of care to the 9.6 million active-duty service members, their dependents, retirees and others.

The plan is also designed to leapfrog DOD to a next-generation EHR capability by offering interoperability with private-sector systems and those at the Department of Veterans Affairs. Indeed, the DHMSM procurement for a commercial system was set in motion only after a grander plan to build a unified DOD/VA system was scrapped in 2013.

As Chris Miller, the program executive officer leading the acquisition, said, "We are not just buying an off-the-shelf system. We're really looking to modernize how the department delivers health care."

Early in the process, DOD officials urged EHR providers to team up with IT service providers and experienced integrators. IBM and EHR giant Epic were the first to announce a planned bid, back in June. Computer Sciences Corp., Hewlett-Packard and EHR firm Allscripts are also expected to go after the contract. PricewaterhouseCoopers, General Dynamics, DSS and Medsphere -- a team with a product based on VA's VistA EHR system -- were the most recent companies to enter the field.

Because DHMSM proposes to transform health care delivery, it's hard to speak of an incumbent player. But Leidos, in its former incarnation as part of SAIC, designed the Composite Health Care System now in use at military hospitals and treatment centers, and the company runs AHLTA, which serves as DOD's current EHR.

Leidos is leading a team that includes Accenture and EHR provider Cerner; it is the fourth team that will go after the contract.

Experience on sprawling and diverse networks that range from hospital centers in the continental United States to far-flung outposts, submarines, ships and aircraft is a sweet spot for Leidos, said Jerry Hogge, deputy group president at Leidos Health Solutions Group.

"We're very well acquainted with the infrastructure that exists," Hogge told FCW on a conference call that included executives from Cerner and Accenture. "It does require that the system be deployed in a low- or no-connectivity environment -- the theater of war -- and our systems are capable of operating in those environments."

The IBM/Epic team made news this summer by announcing that IBM's vaunted Watson supercomputing capability is getting into health care analytics -- giving it a potential edge over its rivals for the DHMSM contract. The Leidos team is stressing the interoperability of Cerner's EHR system.

Travis Dalton, general manager of Cerner Federal, said his company began working on interoperability about 15 years ago because it thought the market was headed in that direction and that functional interoperability would differentiate Cerner from its largest competitor, Epic.

EHR interoperability is still in its early stages and driven largely by certification requirements handed down by federal regulators. But Cerner is a founding member of the CommonWell Health Alliance, an industry trade group that promotes standards for health IT infrastructure, including data interoperability.

"Interoperability is actually key and central to having the data," Dalton said. "If you don't have the data and if you're not open to the data, you can't use the data for predictive modeling and analytics. We think that's crucially important -- not just to interoperate but to actually use that data in a meaningful way to do predictive modeling and really engage the population. That's an opportunity well beyond the mechanics of interoperability. That goes to the managing of a population, which is ultimately what we want to do."

The new system will have to do more than be compatible with VA's VistA. Contracting officials pointed out at multiple industry events designed to educate vendors about the needs of the Military Health System that the population receives about 60 percent of its care from private-sector providers.

"The leadership at DOD has said repeatedly that this is an opportunity for the Defense Department to lead in interoperability," said Jim Traficant, managing director of Accenture Federal Services. "The opportunity to innovate comes from this modular, open, standards-based approach so that you're not locked into a particular model over the next 20 years. You can take advantage of innovation wherever it occurs."

The winner of the DHMSM contract will have a great deal of influence over the direction of EHR systems. Dalton said he envisions an environment in which a military physician could grab an app from the VA or a third-party vendor and have it run on the DOD system on a plug-and-play basis.

"That's the vision -- someday having an app store concept where you plug into the EHR," Dalton said. "That's where this process can lead."

The deadline for DHMSM bids has been pushed from Oct. 9 to Oct. 23 so vendors can deal with a slight refinement to a requirement -- one that tests the ability of systems to swap in components that meet interoperability certification requirements from the Office of the National Coordinator for Health IT. The winning team is expected to be chosen by June 2015.