Defense-VA electronic health record cost pegged at $4 billion

The integrated electronic health record planned by the Defense and Veterans Affairs departments to jointly serve military personnel and veterans will cost $4 billion to develop and will go into service in stages from 2014 through 2017, according to Roger Baker, VA chief information officer.

Baker said the two departments intend to install a bare-bones iEHR in hospitals in San Antonio and the Hampton Roads, Va., area in 2014. This will include middleware software, known as an enterprise service bus, under development through an $80 million contract with Harris Healthcare. The initial iEHR also will include a data repository and a graphical user interface -- the agencies are considering the JANUS GUI developed by the VA in Honolulu, according to internal Defense and VA documents.

This basic system, Baker said will allow clinicians to tap into the existing Defense AHLTA, or Armed Forces Health Longitudinal Technology Application, and the Veterans Health Information Systems and Technology Architecture, or VistA, electronic health record systems while the two departments work on the real challenge of iEHR development, which will involve 127 different medical applications.

Those applications will be rolled out incrementally as they are developed, initially to the first two sites and then to other VA and Defense hospitals through 2017, Baker said at the press briefing Wednesday.

Beth McGrath, Defense deputy chief management officer told the Armed Forces Press service that “the clinical capabilities we’re deploying first are focused on laboratory and immunizations.”

Baker said he and VA remain committed to open source architecture for developing medical record applications, despite a Pentagon report to Congress in April that emphasized the use of commercial software and gave only a passing nod to open source software.

Baker said wished he had read that report more closely before it was sent because he would have requested more language on open source software.

He had high praise for Barclay Butler, the former Harris Healthcare executive tapped in February to head the Defense-VA Interagency Program Office, which will manage iEHR development and deployment. Baker said it was “sheer coincidence” that Butler had worked for the company that won the enterprise service bus contract in March. There is “no way” Butler will have anything to do with the enterprise service bus contract until the period of time designed to handle potential conflicts of interest expires, Baker added.

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