Will the Coast Guard go commercial on health records?

After spending seven years and almost $60 million on an electronic health records system, the Coast Guard is back using a paper-based medical records management process for its roughly 50,000 service members.

That has some members of Congress wondering why the service doesn't just adopt the same EHR system the Departments of Defense and Veterans Affairs are pursuing.

"I would highly encourage you guys to do what's easy and efficient and effective" and follow DOD and VA's lead, Rep. Duncan Hunter (R-Calif.) said at a Jan. 30 House Transportation Coast Guard and Maritime Transportation Subcommittee hearing.

The Coast Guard's electronic health record modernization effort was initially planned as a five-year, $14 million project, but ballooned to more than four times the original price tag over seven years and used 25 different vendors before the Coast Guard abandoned the plan altogether without any reusable equipment or software.

Dave Powner, director of IT management issues at the Government Accountability Office, also voiced his support for adopting the solution chosen by DOD and VA.

"They're ahead of the game, so you could look at lessons learned," he said. "To me, it makes sense to go that route, especially given the fact that we have nothing."

Powner said the key finding in the aftermath of the failed EHR acquisition was that the Coast Guard's executives were "simply not active" in the project's oversight.

Another issue, he added, is that "the Coast Guard decommissioned its older, existing legacy system because it was not compliant with international medical coding requirements," opening the system up to significant cybersecurity risks.

The Coast Guard is taking some steps to modernize its health records management and is "looking with great interest" at what DOD and VA are doing, testified Rear Admiral Erica Schwartz, the service's Director of Health, Safety and Work-life.

"As the chief medical officer, I absolutely would love to go with the DOD and the VA," she said, adding that the Coast Guard has "worked very closely to look at what the DOD was doing to ensure that the operational requirements document that we provided the acquisition officer was very similar to what the DOD system is."

"We're tracking down in that direction," he said, pointing out "we need to follow discipline, that meeting process, or we will end up in messes like other programs in the past," said Rear Admiral Michael Haycock, the Coast Guard's Chief Acquisition Officer.