DOD releases RFP for $11 billion health record project

After more than a year of preparation, the Defense Department released its request for proposals for its new electronic health record (EHR) procurement on Aug. 25. The single-award, indefinite-delivery, indefinite-quantity contract is expected to have a total lifetime cost of $11 billion through 2030.

The Defense Healthcare Management System Modernization was created after Defense Secretary Chuck Hagel scrapped a plan to combine DOD's and the Department of Veterans Affairs' EHR systems into a single solution in May 2013. DHMSM seeks a single, commercial product to be adapted to the military's unique set of needs and requirements, which include full interoperability with the VA's VistA health records system and private-sector interoperability standards. It will reach a population of about 9.6 million service members, retirees and dependents.

Industry has been gearing up for the procurement, with leading IT integrators partnering with established EHR providers and other IT specialists to supply the range of capabilities specified under the contract. IBM, health record provider Epic and medical record systems consulting firm Impact Advisors are teaming up to bid on the contract, while Hewlett-Packard, Computer Sciences Corp. and Allscripts are joining forces in a separate effort. And Cerner, which recently acquired Siemens' health IT division in a $1.3 billion deal, is partnering with Accenture Federal Services and Leidos to pursue the project.

The VA's VistA, which despite the department's other IT and management woes is highly rated by health care providers, could also be a contender to supply the final product. Christopher Miller, the program executive officer leading the acquisition, has said in the past that he expects four to six teams to submit bids.

"We are not just buying an off-the-shelf system, we're really looking to modernize how the department delivers health care," Miller said in an emailed statement. "Ultimately, program success will result in continued improvement in patient safety, quality of care and readiness of forces worldwide."

A peek under the hood of the solicitation gives some hint of the complexity involved. The Military Health System has more than 1,230 locations in 16 countries and 55 inpatient hospitals and medical centers, 352 ambulatory care clinics and more than 300 expeditionary care clinics. Proposals must include details on how the bidders' solutions would work in a variety of scenarios, including the initial care and transfer of a wounded soldier from a combat zone to a garrison hospital and then via air transport to a recovery center in the U.S.

That end-to-end continuity is crucial to saving lives, said Col. Jennifer Caci, commander of the 62nd Medical Brigade, at an industry day in June. "Even something as simple as a soldier's blood type can be confounded by the combat environment or a mass casualty situation, resulting in catastrophic outcomes," she added.

The system also needs to contend with the more mundane but important tasks of corralling medical records when processing new recruits, discharging wounded veterans to the care of the VA and supporting telemedicine for remote physician consultations.

"Modernizing our system will allow us to better serve our beneficiaries and clinicians; it will update software and improve our ability to share health data with the private sector and the Department of Veterans Affairs," said Frank Kendall, undersecretary of Defense for acquisition, technology and logistics, in a statement.

Bids are due by Oct. 9, and a final selection is expected by the end of June 2015. The new system will be launched by the end of 2016 on a limited basis to eight facilities in the Puget Sound region, with departmentwide implementation to follow.