Coast Guard to Adopt Defense Department’s Electronic Health Records

After spending nearly $60 million over seven years on a failed electronic health records project, the U.S. Coast Guard announced Monday plans to adopt the Military Health System Genesis administered through the Defense Health Agency.

The Defense Health Agency contracted with the Leidos Partnership for Defense Health to build a seamless, interoperable electronic records system that could be deployed throughout the Defense Department and integrate with private sector and other health management systems. The Leidos partnership includes health IT companies Cerner Millennium and Dentrix Enterprise on a 10-year, $4.3 billion contract.

The Coast Guard will join the MHS Genesis program, rather than issuing its own contract, defense officials explained. It is unclear whether that will require raising the contract’s ceiling, according to Stacy Cummings, program executive officer with the Defense Healthcare Management Systems program office. The office issued a notice of intent on FedBizOpps Monday noting additional market research will be needed to determine whether the contract will have to be increased.

Rear Adm. Michael Johnston, Coast Guard director of acquisition programs, noted the service is only 2 percent the size of the Defense Department when it comes to personnel, suggesting the cost will be negligible in comparison.

Once the contract revisions are hammered out, the Coast Guard will begin with pilot programs, similar to the manner Genesis has been rolled out at the Defense Department. Those initial pilots took two years to get started, but Cummings said the Coast Guard’s rollout shouldn’t take anywhere near as long.

“Part of that two-year time period was the software configuration which we’ve completed and which the Coast Guard is going to adopt,” she explained during a call with reporters. “Some of the lessons-learned from our [initial operating capability] deployment tell us that the important pacing items are having the infrastructure in place—the IT infrastructure.”

Cummings said the Coast Guard has already started looking at those infrastructure needs to ensure a smooth and timely rollout.

The Coast Guard began looking at alternative options for its health records program in February 2016. Genesis was one of the options brought up in January in a scathing Government Accountability Office report showing the Integrated Health Information System overran costs by $46 million. The project—originally pegged at $14 million—was canceled in 2015 after five years, with little to show for the effort and treasure.

“According to the Coast Guard, as of August 2017, $59.9 million was spent on the project over nearly seven years and no equipment or software could be reused for future efforts,” GAO wrote.

Without any usable technology and the older systems decommissioned during the IHIS project, Coast Guard clinics have been working with paper records.

One oversight official lauded the Coast Guard’s decision to work through Defense Health’s project rather than starting another on its own.

“Leveraging existing agencies’ solutions and contracts is key to federal IT modernization,” Dave Powner, GAO director of IT management issues, told Nextgov on the Coast Guard’s announcement.

The Coast Guard isn’t the only one to turn to Genesis after a failed electronic records project. The Veterans Affairs Department spent almost $2 billion over 15 years trying to build a system in-house. The VA is now in negotiations with Cerner on a projected $10 billion contract to build a system that can integrate with the Defense Department.

“The Coast Guard represents the second federal agency to partner with the DOD in a single electronic health record,” said Tony Kurta, special assistant to the undersecretary of Defense for personnel and readiness. “Together, we are setting the standard across the federal government to seamlessly share health data, ensure readiness of our military forces and deliver the best possible healthcare. At the same time, we are a strong and influential customer driving interoperability and data standards in the private sector.”

The Genesis rollout has not been without hiccups. A Politico report in March quoted aggravated health care staff working through pilots of the records system at four military hospitals in the northwest. Officials from the Defense Health Agency and Cerner acknowledged the early difficulties in a call with reporters the day after the story broke but passed the issues off as normal kinks in any large-scale rollout.

The Coast Guard will be the beneficiary of those lessons-learned, Johnston said.

“They’ve already incorporated all those lessons-learned into their deployment strategy,” he said. “We intend to leverage those as much as possible.”