The Defense Department’s plans to implement a new electronic health record system by December may not be realistic, according to a new audit from the DoD Office of the Inspector General.
In July 2015, the Pentagon awarded a $4.3 billion contract award to a Leidos-Cerner team to modernize DoD’s EHR system. Called the Defense Healthcare Management System Modernization (DHMSM), the integrated system is designed to replace legacy military health systems and promote greater efficiencies by leveraging commercial-off-the-shelf Cerner Millennium solution.
An initial deployment is slated for December, when the EHR will be rolled out to DoD sites in the Pacific Northwest. But the OIG is concerned that the DHMSM program schedule may not meet initial operational capability requirements by the end of this year.
“While the DHMSM program office has identified risks and mitigation strategies, it is still at risk for obtaining an EHR system by the December 2016 initial operational capability date because of the risks and potential delays involved in developing and testing the interfaces needed to interact with legacy systems, ensuring the system is secure against cyber attacks, and ensuring the fielded system works correctly and that users are properly trained,” concluded the OIG report, which was released on Tuesday.
However, speaking that same day at the ONC Annual Meeting in Washington, DC, Stacy Cummings, program executive officer for the Defense Healthcare Management Systems program, gave no indication that the EHR implementation schedule might be at risk because of potential delays with interfaces and inadequate training.
“We’re going to be doing testing both prior to and during the deployment to ensure that our interfaces are working, to ensure that the workflows are working, as well as to make sure that it’s operationally suitable for our needs in the Department of Defense,” said Cummings, who oversees DoD’s EHR modernization, including the operational, data exchange and interoperability initiatives.
She added that DHMSM is investing in training, change management and coaches to aid the deployment of the new EHR. “As we deploy to a location, we’re not just training people how to use the system,” said Cummings. “We’re actually teaching them how to take advantage of the business processes and the decision support that is inherent in the commercial tool.”
Nonetheless, the OIG recommended that Cummings, as the program executive officer for Defense Healthcare Management Systems perform a schedule analysis to determine whether the December 2016 initial operational capability deadline is achievable and continue to monitor DHMSM program risks and report to Congress quarterly on the progress of the program.
In response to the OIG, Cummings’ office said it is confident that it will achieve initial operational capability later this year.
Yet, DoD auditors noted that the program executive officer for Defense Healthcare Management Systems did not provide documentation to support its contention that the DHMSM schedule is on track. “Therefore, we ask that the Program Executive Officer reconsider and perform a schedule analysis to determine whether the initial operational capability deadline is achievable,” insisted the OIG.
David Norley, director of government affairs and acquisition management for Defense Healthcare Management Systems, contends that DoD is still confident it can reach an initial operating capability by the end of the year and that the DHMSM program does not see the value in doing a separate schedule analysis.
“Yes, the IG report does highlight that there is schedule risk for us in meeting the December 2016 deadline,” acknowledges Norley. “But, I don’t think that’s something that we didn’t already know. Nobody ever said that it would be easy.”
In addition, he notes that the IG report also “gives us a glowing, thumbs up as to how DHMSM goes about conducting business—and we’re really proud of that.” As Norley points out, the award to the Leidos team took place in “close to record time” and without a protest from losing bidders.
A spokeswoman for Leidos declined to comment on the OIG report.
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