A defense think tank says the government may regret its plan to lock the U.S. Defense Department into a 10-year contract with an electronic health-record vendor.
The Center for a New American Security released a report that sharply criticizes the department's procurement process for a new EHR system, which is expected to cost $11 billion over the life of the contract and has attracted fierce competition among four bidding teams.
“DOD is about to procure another major electronic (health-record) system that may not be able to stay current with—or even lead—the state-of-the-art, or work well with parallel systems in the public or private sector,” warn authors, who include retired Gen. H. Hugh Shelton and former Veterans Affairs Chief Technology Officer Peter Levin.
“We are concerned that a process that chooses a single commercial 'winner,' closed and proprietary, will inevitably lead to vendor lock and health-data isolation,” they conclude.
Levin added in a interview that the long life of the contract will prevent the department from responding flexibly to changing technologies. It would be akin to having given a 10-year contract to BlackBerry in the late 1990s that looked reasonable at the time and foolish today, he said.
Levin also said he fears DOD officials "think they'll be able to deploy right out of the box,” using one of the large vendor's systems, which are “notorious for their lack of interoperability and lack of choice.”
To avoid those pitfalls, Levin said, the DOD should be adapting the open-source VistA system used by the VA, and he hopes the report influences officials to make a better decision.
Levin was careful not to endorse a particular bidder the contract, although one of them proposes building a system for the DOD on the VistA framework. And PricewaterhouseCoopers, the leader of that bid, believes the new report is a tacit vote for its approach.
“Our approach, leveraging open-source, seeks to give government flexibility as technology evolves," said Scott McIntyre, the consultancy's U.S. public sector managing partner. "An open-source approach doesn't lock you into a single vendor or single architecture,” he said. “I hope (the report) gets the attention the authors intended it to.”
The report adds fuel to the competition for the lucrative EHR bid. The DOD received four bids from teams that include many of the biggest players in health information technology and government contracting.
The deadline for bids passed in October and the contract isn't expected to be awarded until this summer. In the meantime, the rivals are working to nudge the process in their favor.
In January, IBM and Epic unveiled an advisory committee composed of executives with experience implementing Epic EHRs. Soon after, PricewaterhouseCoopers announced that Google was a member of its bid (although it had been all along).
A bidding team with government contractor Leidos, Accenture Federal Services and Cerner Corp. has been relatively low-key with its campaign. Leidos has been buying promoted ads on Twitter to tout the bid. “We have a reliable, innovative, #interoperable DHMSM solution that meets the health IT needs of our military,” stated one seen in January.
They've also dispatched lobbyists to help them make their cases.
IBM has two lobbying groups on the case in addition to its own efforts, according to the Senate's Lobbying Disclosure Act Database. Since July 2014, IBM has paid Prime Policy Group $60,000 for work on the DOD contract in the Senate.
IBM also retains Cavarocchi Ruscio Dennis Associates, which has experience lobbying the House of Representatives and Defense Department concerning electronic health records.
Epic's lobbying firm, Card & Associates, does not list the Defense Department or the DOD contract as a lobbying issue.
Leidos and Accenture have lobbied for the DOD contract on their own behalf, according to records. Cerner relies on lobbyists Cassidy & Associates regarding “health information IT” with the department.
Follow Darius Tahir on Twitter: @dariustahir