HHS floods market seeking health IT proposals

Bids for prototype networks could top $60 million, integrators say

Major systems integrators with experience in the health care information technology field are considering offering bids on the Department of Health and Human Services' National Health Information Network (NHIN) proposal, which HHS officials released last week.

HHS has proposed awarding contracts for six prototype networks, whose combined value could exceed $60 million.

Dr. Richard Pico, chief medical and technology officer in Perot Systems' health care division, said the contracts probably will be worth tens of millions of dollars each because of their scale and scope. Perot Systems plans to bid on the NHIN proposal, he said, based on the company's experience in providing health care IT and managing large health payment systems.

The NHIN request for proposals asks vendors to design and develop a prototype network that could operate in three health care markets.

The proposal states that the prototype must be suited to real-world health care environments, such as doctors' offices, hospitals, clinics and labs. Vendors must demonstrate how their prototypes would exchange electronic health record (EHR) information among health care providers in different settings.

Winning vendors will also need to build at least one system or application for population health data, such as a solution that provides surveillance of epidemics or supports clinical research using data containing no personal identifiers.

Dan Garrett, vice president and managing partner of Computer Sciences Corp.'s Global Health Solutions Division, agreed that the NHIN contracts would be worth millions of dollars.

Garrett said CSC would bid on the NHIN proposal, but added that the company is undecided about competing as a prime contractor.

CSC plans to apply experience it has gained as a major provider for the United Kingdom's e-health care project. CSC won a $1.7 billion local service provider contract in late 2003. Garrett said the U.K. system and an NHIN prototype could have common technology and architecture elements.

Mark Roman, vice president and global health care leader at EDS, said the company might offer a bid on the NHIN proposal. Northrop Grumman might also submit a bid, said Robert Cothren, the company's chief technologist.

In addition to the NHIN proposal, HHS released separate RFPs last week seeking vendors to develop e-health privacy and security policies, create EHR data standards, and certify EHR software. Neil de Crescenzo, health care leader of IBM's Business Consulting Services, said the company is interested in all of those projects, but he declined to specify which proposals IBM would bid on.

Privacy, standards and certification are as important to developing a nationwide e-health care system as the NHIN is, de Crescenzo said. "The best way to think about them is in a holistic sense," he said.

Dr. David Brailer, national health IT coordinator at HHS, said he viewed the privacy and security RFPs as linchpins in the agency's health IT strategy. If the department's EHR plans are to succeed, the public needs assurance that e-health care information is secure, he said.

Standards are also needed to ensure progress, Brailer said, a point that HHS' certification RFP reinforces. It states that more than 200 EHR systems are in the marketplace, but no common definition of an EHR or criteria for evaluating EHR functionality and interoperability exist.

Little coordination has occurred among vendors to make their products interoperable, said Charlene Underwood, director of government and industry affairs at Siemens Medical Solutions and chairwoman of the Healthcare Information and Management Systems Society's EHR Vendors Association.

Vendors want to meet the interoperability challenge, Underwood said. But to do so, she said, companies will need more than one seat on the public/private American Health Information Community advisory panel, which has been created to coordinate the development of a national EHR system. "We need seats at the table, because we're the ones doing the coding," she said.

Digital imagery, a missing piece?

Dr. Richard Pico, chief medical and technology officer in Perot Systems' health care division, said his company intends to include medical digital imagery in its prototype of the National Health Information Network (NHIN). Other integrators are still assessing the inclusion of digital imagery in their bids for the Department of Health and Human Services' project.

Medical image files can be as large as 125M and require a broadband network to transmit, Pico said. "If you are going to have a prototype of the NHIN, then you have to demonstrate your highway can handle big packets," he added.

— Bob Brewin


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