Team lays out plans for virtual med system

Officials from the departments of Defense and Veterans Affairs as well as the Indian Health Service last month laid out their plans for a multibillion-dollar federal computer-based patient-record system that could pave the way toward a national standard for "virtual" medical records.

DOD and VA officials—- newly joined in their partnership by IHS and Louisiana State University—- told more than 100 companies attending a briefing that the contract they hope to award by October will cover development of a core application or system called the Government Computer-Based Patient Record. Officials expect the G-CPR will function like a standard operating system or platform, off of which individual agencies could operate their own specialized medical-information applications. Eventually, G-CPR partnership members believe, the system could become the standard the private health industry uses to fully automate their patient records.

"It has been touted that the outcome of the G-CPR...may lead to the national CPR," said Lt. Col. Rosemary Nelson of DOD Health Affairs.

The push for the G-CPR is grounded in many health care providers' belief that they can provide a patient with faster, better health care if they have quick electronic access to the patient's detailed medical history no matter where that patient travels or moves.

At first, as many as 40 million people may be served by the G-CPR; DOD covers the health care needs for 8.4 million people, and the VA provides health care benefits to 27 million veterans. IHS covers 1.4 million Native Americans, and the LSU Medical Center system has the potential to serve Louisiana's entire population of 4.3 million. LSU joined the project last month because its system regularly treats veterans and reservists, and the center has a constant need to share medical information with the federal government.

"To the extent that federal agencies are able to set a standard and also do one with a state, I think that that body of work cannot be ignored," said Richard Ferrans, chief of the medical information and telemedicine section at the LSU Medical Center. "This may provide an important forerunner of a [national] standard—- if not 80 percent of [the standard]."

The cost to build the G-CPR, including all the hardware and applications for agencies to plug into it, could run as high as $3 billion, said Air Force Col. Lynn Ray, program manager for a major DOD health care information system project.

It is possible that the number of people served by a G-CPR standard could increase if more federal agencies or states are added to the partnership. The State Department, which is responsible for the health care of Marines at U.S. embassies, is being briefed on the G-CPR project, and other agencies and organizations are welcome to join the partnership.

DOD and the VA said last month they planned to award the G-CPR contract to a company chosen from winners of another DOD health care information contract, the Defense Medical Information Management/ Systems Integration, Design, Development, Operations and Maintenance Services II. D/SIDDOMS II, a $4 billion contract designed to make military patient records accessible electronically, is expected to be awarded within the next two months.

Randy Koran, director of acquisition and management for DOD's Health Affairs Branch, said the prime contractor for the G-CPR will likely come from contractors chosen for Lot III of the D/SIDDOMS II contract. Lot III, with an estimated value of $2.5 billion over five years, covers services such as systems design, development, operations and maintenance.

Agencies interested in hooking up to G-CPR could use other federal contracts to buy specialized software and hardware they need to interface with the system, partnership members said. Those vehicles include the VA's $1.5 billion Procurement of Computer Hardware and Software, the General Services Administration schedule and the National Institutes of Health's governmentwide contracts, said Dennis Maloney, contracting officer for the VA.

Agencies and LSU have not determined how costs for developing the core G-CPR will be divided, the Air Force's Ray said. But once the G-CPR has been developed and members of the partnership begin buying hardware and software applications that are compatible with the G-CPR, economies of scale may help keep total costs of the medical information-sharing initiative within current estimates, LSU's Ferrans said.

Federal and LSU officials have asked industry to submit plans for the system by Feb. 20. More industry comments are due in March after the partnership has released a draft statement of objectives.