VA and Defense drop vendor-specific database requirement for joint pharmacy system

The Defense and Veterans Affairs departments have dropped a mandate that any vendor planning to bid on the pharmacy system for the integrated electronic health record use a drug database supplied by First Databank, a San Francisco-based subsidiary of media conglomerate Hearst Corp. Nextgov first reported the requirement on June 5.

VA quietly removed the requirement to use First Databank in an attachment to a new version of the iEHR pharmacy performance work statement posted to the Federal Business Opportunities website on Aug. 10. This attachment, buried on page 93 of a 126-page document, removed all language in previous versions related to First Databank and instead said the joint pharmacy system “shall support a commercially available drug database as the enterprisewide drug database.”

The new version of the performance work statement added, “The iEHR pharmacy product shall provide automatic updates of a commercially available drug database, including automatic updates of customization tables.”

A number of other companies provide drug database software -- which identifies prescriptions by national drug codes assigned by manufacturers -- including Cerner Corp., the Micromedex division of Thomson Reuters; Medi-Span from Wolters Kluwer Health; and Elsevier/Gold Standard.

VA also initially required potential bidders on the pharmacy project -- the first major procurement for the iEHR -- to use a clinical decision support system provided by First Databank. Clinical decision support systems are powerful software tools that help clinicians detect potential adverse drug interactions and determine whether a patient has an allergy to a particular class of drugs. VA also dropped the requirement that potential iEHR pharmacy bidders use the First Databank clinical decision support system, and said bidders could offer any commercial product.

In 2011, the attorneys general of Kentucky and Michigan slammed First Databank and drug wholesaler McKesson Corp. with lawsuits charging the companies conspired to inflate prices for drugs prescribed under the states’ Medicaid programs.

The iEHR pharmacy system will manage 190 million Defense and VA drug prescriptions per year for nearly 10 million TRICARE beneficiaries and 8.5 million veterans.

Defense and VA plan to issue the request for proposals for the iEHR pharmacy procurement in October, with bids due in September and an award planned for March 2013, Anne Marie Vasconcelos, acting division chief for the project in the Interagency Program Office told industry officials at a briefing Aug. 14.

Barclay Butler, the director of the Interagency Program Office, said he expects the iEHR pharmacy system will be fielded in Defense and VA hospitals in Hampton Roads, Va., and San Antonio in 2014, along with an immunization system, a graphical user interface, and access control and identity management software.

Butler said that when fully deployed in 2017, the iEHR will include 54 medical applications. VA Chief Information Officer Roger Baker has pegged development costs at $4 billion.

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