It appears from early reports that IBM and Epic will partner for a bid on a $11B project to develop an EHR for the military. Perhaps unknown to the readers of this blog is that the military has wasted many billions of dollars in the past on multiple, unsuccessful attempts to develop an EHR. Here's a link to a blog note from nearly nine years ago about this topic: A Peak at the Military Healthcare Information System. Global IT failures are common (see: Modeling the Costs of IT System Failures Globally), particularly by governmental branches and agencies. Here's a link to the article announcing this new IBM/Epic partnership (see: IBM-Epic Team to Vie for $11 Billion Pentagon IT System) and below is an excerpt from it:
International Business Machines Corp. (IBM), the world’s biggest computer services provider, and Epic Systems Corp. will team up to compete for an $11 billion project to manage U.S. troops’ electronic health records. IBM announced its plans to bid today, even before the Defense Department formally starts the competition for the information-technology system. Rival bids may come from Accenture Plc (ACN) and Northrop Grumman Corp. (NOC) The winner gets one of the biggest opportunities in federal information technology, where new projects are under scrutiny after the flawed rollout of the Obamacare website. A better Pentagon system is needed so troops’ health records can be shared quickly with the Department of Veterans Affairs, which is struggling to reduce backlogs in disability claims.“I hope people expect results, because this is where we show up,” Andy Maner, managing partner for IBM’s U.S. federal division, said in a phone interview. “We don’t bid on everything, but when we do, we want to change the world.”
The Pentagon’s solicitation for the contract, possibly with a 10-year duration, may be posted as early as next month, Maner said. IBM, based in Armonk, New York, already has more than 100 employees working to develop a proposal, he said.“This has been a thing we’ve had circled for more than three years,” Maner said....The planned system, which will replace the older one, will track U.S. forces’ health records no matter where they receive care, whether on base, on a ship, in a military hospital or close to combat. It will handle the health records of 9.7 million beneficiaries, including active-duty military, retirees and their dependents. “Service members, their families and health-care providers who care for them deserve the best health care our country can provide,” Carl Dvorak, president of Verona, Wisconsin-based Epic, said in a statement. “They would benefit from an integrated system that leverages best practices from other large and successful health-care organizations.
First of all, I want to recognize Mr. Andy Maner of IBM's federal division for what may be one the most inane quotes ever from a corporate executive: “We don’t bid on everything, but when we do, we want to change the world.” Maner is a government retread who has taken advantage of the revolving door and soft-landed in IBM's federal division. By comparison, the quote from Carl Dvorak of Epic about the military EHR is reserved and actually makes some sense: “[The military] would benefit from an integrated system that leverages best practices from other large and successful health-care organizations.
Judith Faulkner has developed a keen understanding that many hospital CEOs/CIOs are desperately searching for solutions and are very willing to take their marching orders from Epic to deploy an EHR (see: Some Hospitals Can't Get Past the Final Epic Deployment Step: the "Judy Check"). Unfortunately, this same rule does not apply to the military brass and their healthcare system. The closest analogue to the military healthcare system I can think of is the VA health system and we know how this is going. The generals and admirals in charge would never admit to any degree of incompetence and they are surrounded by subordinates who will confirm their bosses' talent. Our federal government is highly inept at developing information systems and even contracting for them. By way of evidence of this, I cite our recent experience with healthcare.gov (see: Major Conflict of Interest with QSSI, the Contractor for the Health Insurance Exchange; The Health Insurance Marketplace: A Case Study of Incompetence).
So what's is the eventual fate of IBM and Epic should the military buy their inflated rhetoric and accept their proposal for yet another shot at a military EHR? By the way, this is by no means a certainty because the predisposition of the military brass would be to choose a missile and tank contractor for their EHR project. I predict, should the IBM and Epic proposal be accepted, that the project will get bogged down by the federal bureaucracy/malaise and that all of the other Epic hospital clients will eventually start to feel the pain.
:: Update on 6/24/20014
See: The Best Thing For Epic Might Be to NOT Win the DoD Contract
The VA VistA system is not bad and sure like any software needs constant updates and there are different from ends that can function well with the VA back end, Medsphere is one who created a commercial VistA system, and the VA is working on a web based VistA system. I'll defend the IT folks here a bit as I'm sure they have a burial ground of all kinds of software sandboxes that didn't work, meet specifications and so on or maybe were too just cost prohibitive. Here's another perspective on the VA Scheduler from someone who wrote an EMR years ago and my take on some of this..not making it right but a different angle if you will. With the FBI now it is a who dunnit deal, who spread the bug in the scheduler through out the system and if I were on the IT team with this, I would be mad in the fact that nobody told me, but users will be users.
http://ducknetweb.blogspot.com/2014/06/fbi-enters-va-investigation-who-figured.html
When you talk about integrating VA with DOD ALTHA medical records system, now you have something very different going on as DOD "likes" their EMR and for good reason as it's been a while since I've seen ALTHA but they have items in there that do not exist in the VA system, i.e. battleground care, etc. It's designed different but the over all meds and general medical data is all there as well.
DOD 4 years ago created an EMR for the White House too. So when you talk integrating the two systems it's a lot of work and time and money. Like I said DOD likes their system as it works. There are also some smaller commercial EMR installations with DOD too that integrate with the ALTHA system. Everyone talks about the VA but never ALTHA DOD EMR.
I'm watching this too as when you buy the Epic system if you want analytics you also have to purchase a Clarity server and that's more money too, aahhh..a few Epic buyers find this out later when they need more analytics than what comes with Epic, Kaiser did and that's what they run and I don't know even if Kaiser has their analytics in real time yet but that's how the reports synch via their facilities.
So Clarity server if you want big time analytics like everyone does today, well there's more cost on top of the Epic System and Kaiser bought and developed their Clarity server apps and functionalities separate from Epic. Middleware is what they need and you can read about this killer product as it also uses a Clarity server in the cloud and sits on top of any EMR and any system can communicate..keep your eyes open as this is the new HIE..programmer is sharp and was product manager fro BEA software years ago and is a full on engineer who's products were sold to Oracle a few years ago and became weblogic server and more. I'll be doing an updated post on them again soon. I only found them as I read about their product and they called me and said I was the only blogger that wrote it up correctly and again that goes back to my hands on days of writing an EMR.
http://ducknetweb.blogspot.com/2014/03/another-answer-to-interoperability-with.html
I shared this with an engineer friend at Microsoft and he took big notes as there's nothing out there like this and yes it's in beta at a hospital as well with a couple oncologists and can connect patients as well to let's say a couple doctors looking at the chart at the same time if they want.
I don't always tell the best stories when writing articles or blog posts but I do give you reality I hope in a way you can understand.
Posted by: MedicalQuack | June 14, 2014 at 01:44 AM