Coast Guard to implement same Cerner EHR as DoD

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The U.S. Coast Guard will implement the same Cerner electronic health record system that the Department of Defense has so far installed at four military sites in the Pacific Northwest. The two agencies made the joint announcement on Monday.

A branch of the U.S. armed forces, the Coast Guard had been considering both government and commercial-off-the-shelf EHRs as possible solutions to replace its current paper-based records. But in the end, the agency decided to opt for DoD’s system—called MHS GENESIS—that leverages the Cerner Millennium platform.

“The Coast Guard plans to adopt the MHS GENESIS system to all its clinics and sick bays,” said Rear Admiral Michael Johnston, the Coast Guard’s director of acquisition programs and program executive officer. “Approximately 6,000 active duty Coast Guard members receive their medical care and dental care at DoD hospitals and facilities.”

Johnston noted that the Coast Guard is a military service and its concept of operations, a document describing the characteristics of the proposed system, mirrors DoD’s own EHR requirements.

“We’ve done the analysis, and this is the best way forward,” he added. “In February of 2016, the Coast Guard’s Electronic Health Record program was established to acquire this enterprise EHR capability. The Coast Guard determined the best possible solution for satisfying our requirement is to join DoD as an integrated partner for MHS GENESIS.”

This isn’t the first time the Coast Guard has collaborated with another agency on an EHR. In 2010, it signed an interagency agreement with the State Department for the Integrated Health Information System (IHiS) to reduce the overall costs to both agencies. However, in 2015, the Coast Guard decided to terminate the IHiS project because of financial, technical, schedule and personnel risks.

Also See: Coast Guard goes back to drawing board with new EHR

According to Stacy Cummings, program executive officer for Defense Healthcare Management Systems, the Coast Guard and DoD will together set the standard for seamlessly sharing health data across the federal government.

“This cutting-edge technology will supply both the (Military Health System) as well as the Coast Guard providers with necessary data to collaborate and make the best possible healthcare decisions for service members, veterans and their families,” Cummings says. “We’re really excited about the Coast Guard’s decision to join the MHS GENESIS team. We think that there’s very good alignment around standard processes and a common group of beneficiaries that often move back and forth between the Coast Guard and the DoD facilities.”

To coincide with the announcement about its partnership with the Coast Guard, DoD on Monday issued a notice on that it “intends to issue a sole-source modification” to the 10-year, $4.3 billion contract the agency awarded in 2015 to a Leidos-led team to modernize its EHR with Cerner’s Millennium—the same system that the Department of Veterans Affairs plans to procure.

“The scope being added under this modification will allow for the ordering of all services and additional capabilities necessary to maintain a standard solution baseline with the VA and USCG as they implement the solution,” states DoD’s notice. “The total ordering ceiling will be updated to accommodate the additional services and capabilities, but the period of performance of IDIQ contract N00039-15-D-0044 will remain unchanged. Because of the necessity of maintaining a single standard solution baseline, the Leidos Partnership for Defense Health is the only source for the required services.”

Cummings said the Coast Guard will be joining DoD’s EHR program and contracting office as part of the partnership. When asked if the total ordering ceiling for the Leidos contract would increase as a result of the Coast Guard’s participation in the program, she replied that there’s “more to come” on the overall value of the procurement.

“As we complete the actions to bring the Coast Guard into the MHS GENESIS fold, they’ll follow a similar acquisition process in that what we’ll want to do is have them deploy to one or two sites—like we did—do an evaluation to make sure that the software baseline, the technology, as well as the infrastructure meets the needs of the users,” Cummings added. “Our intention would be to fold them into our deployment strategy as appropriate, knowing that they are located in the geographic locations that are similar to the geographic locations that the DoD is deploying to.”

Because DoD has already deployed MHS GENESIS to four military sites in the Pacific Northwest as part of the EHR’s initial operating capability phase, she contends that the lessons learned and completed software configuration from that deployment will not only benefit the Coast Guard’s implementation but also the VA’s installation.

“Having a common software baseline in a common data center that uses the same policies and processes from a cybersecurity perspective as well as database management, will allow us to get efficiencies across the federal government,” according to Cummings. “The work that we’re doing now in DoD will benefit both the Coast Guard and the VA. And, as we move forward together, we’re going to be able to make the best decisions for all of the partners.”

Cummings acknowledged that latency issues in the EHR log-in process were identified during the initial implementation. “We have found that our DoD cybersecurity requirements have led to slowness in logging in,” she said. “We’ve actually cut that down significantly. We’re continuing to work on how to balance those cybersecurity requirements with the circuits, the reliability and the speed so that we can have a really good experience for our users.”

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