Four teams of health information technology vendors and government IT contractors hoping to build a new electronic health records system for the Department of Defense submitted their bids at the end of October for a project with an estimated worth of up to $11 billion.

Health Data Management asked each team to explain what each member brings to the project, areas of weakness that the team has to work on, and why that team should be selected. The teams of IBM/Epic/Impact Advisors, and Computer Sciences Corp./Allscripts/Hewlett-Packard, did not respond to requests for an interview.

Two teams participated: PricewaterhouseCoopers/General Dynamics IT/DSS Inc./Medsphere, and Leidos/Accenture/Cerner/ Intermountain Healthcare. Here are their pitches:


The PWC team highlights the electronic health records expertise of DSS and Medsphere, both of which are veteran vendors selling commercialized versions of the VistA EHR that the Department of Veterans Affairs uses. VistA--designed for the federal government marketplace--is a proven and highly scalable system and the commercialized versions are essentially the same system, says Dan Garrett, leader of the HIT practice at PwC. That means if selected, the team would be giving DOD the functionality, features and source code around VistA without any tie to the VA. And that version of a DOD EHR, if selected, would far more easily integrate with health information systems of both the Military Health System and VA, Garrett contends.

Further, DSS and Medsphere have the best EHR tools available to serve soldiers with all inpatient and outpatient information--including mental health and dental records--in the same EHR, he argues. Garrett also asserts that the DSS/Medsphere systems are furthest along in secure messaging and workflow capabilities.

The team will save taxpayers money as the core VistA-based EHR systems have been built and work, Garrett says, adding he expected the team’s bid to be lower than others, and also have lower maintenance costs over time. Because the product developed for DOD would be based on open source technology, any team member can innovate and add features and functions to the product, he explains. That would bring lower costs to operate and the system would be open to improvements at any time.

Both PwC and General Dynamics IT have extensive experience with DOD, Garrett says. If selected, PwC would be the prime contractor and handle such areas as program management, physician adoption, and with General Dynamics would jointly develop workflow designs. General Dynamics also will handle implementation, care delivery transformation and systems integration, among other tasks.

Asked where the team may fall short, Garrett says the project has been incubating for a couple of years and a primary weakness already has been addressed. PwC early on identified the need for more integration talent on VA and DOD health IT systems and acquired specialty consulting firm The Ray Group.


The Leidos team has a weapon no one else does, the inclusion of a large and prestigious provider--Intermountain Healthcare--as a real-world test bed.

Intermountain is implementing Cerner EHRs and will play a key advisory role on a range of issues to meet DOD specifications, says Travis Dalton, general manager of Cerner Federal. These issues include platform-independent applications, clinical decision support, workflows, clinical systems architecture and governance.

With about 60 percent of military healthcare delivered in commercial hospitals, lessons learned at Intermountain will be valuable, and Cerner’s interoperability capabilities are the best within the teams vying for the contract, says Hogge. Adds Dalton of Cerner Federal: “From our perspective, it’s more than technology, but a philosophy of openness, of going beyond HL7 and point-to-point interfacing.”

Cerner partners with more than 20 health information exchanges and connects to more than 125 EHRs, Dalton adds. The company also is active in developing new integration technology, called Fast Healthcare Interoperability Resources (FHIR), that is gaining momentum as an open healthcare data standard, and Intermountain also is part of the process.

If selected, Leidos, which focuses on commercial and federal health information technology projects, will serve as prime contractor. Accenture has considerable change management and training capabilities and both companies have experience with the VA and Military Health System, says Jerry Hogge, deputy group president at Leidos Health Solutions Group.

The pitch to DOD is that the Leidos team--which includes Henry Schein as a subcontractor for dental technology--offers modern information systems and can be trusted to deliver on time and on budget, with a focus on innovation that will serve the military well during a 10-year program.

Asked where the team needs to get better, Hogge says it continues to seek appropriate and talented subcontractors that meet socio-economic requirements of government contracts, such as women, disabled or minority-owned businesses. Aside from that, he sees no other areas where the team needs enhancements.

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