A New Era for our Military Health System

flying cadeuciiThe last day of October was the deadline for proposals in response to the U.S. Department of Defense’s call to overhaul its electronic health record software, also known as the Defense Healthcare Management Systems Modernization (DHMSM). PwC’s proposed solution, called the Defense Operational Readiness Health System (DORHS), seeks to bring innovations from the commercial marketplace to the military health system by using technology that is seamless, proven and reliable.

With team members DSS, Inc., Medsphere Systems Corporation, MedicaSoft and General Dynamics Information Technology, PwC’s goal is to enable every healthcare professional to provide the finest medical care possible to members of the military and their families during every phase of service, through retirement, and assist the Defense Health Agency in its continued business transformation to help implement and manage effectively the world’s largest healthcare delivery system.

In order for doctors, military personnel and their families to make the best healthcare decisions possible, they need to be sure that they have all of the facts. Access to complete medical records and patient data, no matter where care is delivered, is vital. PwC’s solution will create a single source for all medical records, giving providers what they need when they need it, without having to worry about delayed, lost or incomplete medical information.

In a first for a full EHR deployment of this size and scope, the EHR system employed in PwC’s solution leverages open architecture technology created in the collaborative development environment hosted by the Open Source Electronic Health Record Alliance (OSEHRA). In a recent clinician survey of EHR software, WebMD’s Medscape EHR Report 2014, participating physicians rated their EHR systems across multiple domains.  The system built on the open architecture approach proposed by PwC scored the highest overall as well as in key categories such as “Satisfaction” and “Usefulness as a Clinical Tool.”

Recognizing that care for service members and dependents involves providers both inside and outside the Military Health System, including private sector doctors and hospitals and the VA healthcare system, the DORHS solution places high priority on interoperability with other healthcare organizations. The DoD’s system would be able to seamlessly interact with critical entry points, such as civilian labs, specialty clinics and local hospitals. Medical professionals will be able to share information across a wide variety of EHR systems, improving both the quality of the care they deliver and patient safety.

The open architecture and open source core of the DORHS solution prevents the federal government from being locked into a single, proprietary or “closed” technology and the associated “vendor lock.” Further, the broad set of users and developers engaged with the open technology provide a deeper pool of innovation that can provide the DoD with access to advanced technology for years to come.

Security and the protection of personal health information was a critical factor for our bid and solution. The system that DoD chooses needs to be able to exchange highly personal information with little fear of breaches or corruption. The DORHS solution was designed to meet the high DoD standards for cyber security.

Our solution is able to securely share vast amounts of data while employing the kind of cyber threat prevention, detection and response methods that protect our national defense systems. And, as a result of the open architecture system, we will be able to more quickly detect and resolve technology issues.

The team that has assembled this product has put in place more than 2,000 federal and commercial healthcare systems, and that experience translates into decades of user experience and DOD-specific clinical care guidelines already built into the system. Instead of having to toggle between multiple modules and interfaces from a system designed only for commercial use, doctors, nurses and technicians will use a single, common interface and be guided by the treatment protocols that the DoD  prefers, helping them to more easily deliver consistent, high quality care.

Having access to a patient’s full medical history, including dental and mental health records, helps reduce the risk of dangerous medical errors and improves patient safety. From the initial intake point forward, DORHS is reliable, responsive and able to adapt.

Since DORHS uses existing EHR technology already developed and funded with taxpayer dollars, it is remarkably cost effective. And because of its open architecture, there are no expensive fees required in order to make the system compatible with other vendors.

DoD’s decision on the DHMSM contract will undoubtedly have a huge impact on health care innovation in the future. Almost 10 million active duty members, military retirees and their dependents will rely on this new system for years to come.

Those who dedicate their lives to serving our country and their families deserve no less than the very best.

Dan Garrett is with PwC’s health care practice.

7 replies »

  1. VA Vista is used broadly outside the VA and is open and fully interoperable. The DoDs system is neither. Do you know how much the proprietary systems cost ? How interoperable they are? How satisfied their users are? What’s the fastest and least expensive path to an integrated military / veteran system?

    And in regards to fit for purpose, the leading proprietary systems are unfit and will cost billions to make fit. They were built for academic medical centers and commercial health care networks. They were not built for agency based health care.

    Connecting DoD to VA is not as much a technical issue as a political one. The best way to interoperable health is for them to use the same EHR then there are no technical excuses.

  2. This farce on VA and DOD EHR HIT has been going on for years. The problem is that NONE of the devices are fit for purpose and NONE of them interface with eachother. How many $ billions for this tragedy?

  3. John, yes commercialized open source is ideal for the government particularly for the DoD, the veterans and the taxpayers.

    We have already created the EHR rated #1 by physicians, which takes care of wounded warriors, is full open and interoperable and that we all have and continue to pay for. The question is why would the DoD not leverage a COTS VistA and create one seamless medical record for our warriors.

    Selecting an expensive proprietary system built for commercial health systems is a disservice to our veterans and the taxpayers.

  4. VistA is fully open source. Medsphere provides services and packaging of VistA to help organization build and maintain their own EHR’s on VistA. We work with the Indian Health Service on their VistA-based EHR and we have commercialized it for mainstream provider organizations. We contribute code back the the main OSEHRA VistA open source project. Our model is must like Redhat’s with linux. We help organizations benefit from open source without taking on all the work and risk of becoming their own software companies.

  5. Opinion. Regularly scheduled post from Ceci and PwC.

    Next question:

    Open source? US Government? Good idea? Bad idea?