Inside the Epic, IBM, Impact Advisors DOD EHR bid

This story is the first in a series of three containing interviews with the three teams contending for the Department of Defense's Healthcare Management System Modernization project bid.

Creating an EHR system from a sprawling organization like the Department of Defense is likely to be a daunting task for anyone. After all, a system with 9.59 million eligible patients and an $11 billion contract in the mix is nothing to sneeze at.

However, Epic, IBM and Impact Advisors seem cool and confident in their approach.

Epic and IBM announced their intention to bid for the contract last June and added Impact Advisors to the team shortly thereafter. The team announced the formation of an advisory group in January consisting of more than 17 executives from 13 healthcare organizations to provide pre-planning advice to the team on best practices throughout the bidding process and during the initial go-live phase if the IBM-Epic team is awarded the contract. In February, the agency announced that the team had made the final list of contenders, alongside a team led by Allscripts, Hewlett-Packard and Computer Sciences Corp. and another led by Cerner, Leidos, Accenture and Henry Schein.

In an interview with Becker's Hospital Review, representatives from Epic, IBM and Impact Advisors discussed the benefits of Epic's widespread software, IBM's experience in working with the military and Impact Advisors' implementation advising. Andrew Maner, U.S. federal leader at IBM, Leslie Karls, U.S. federal and global services executive at Epic and Lydon Neumann, vice president of Impact Advisors discussed the future of DOD's health system should their team win the contract and the challenges the team will face.

Note: Answers have been edited for length and clarity.

Question: What does your solution uniquely bring to the Department of Defense?

Leslie Karls: Epic is the only EHR software partner that brings successful EHR implementation at [its] size and scale. I think it also brings a whole group of customers who bring things that are leading the industry. I think the DOD will value the type of pedigree that our customers bring and [that they share] clinical content. Our customers have a community library, which means they are all willing to share with each other. Our customers have open arms and would love to be able to partner with a customer of [the DOD's] caliber. One of the things important to the DOD is interoperability. We know that 60 percent of care for veterans and their families is in the consumer sector. Epic customers already share 9 million records with their customers and with each other monthly. No other vendor has that kind of interoperability and exchange.

Andrew Maner: We bring this massive experience that IBM has. We bring Impact Advisors, which is ranked No. 1 in its space as well. Epic is the No. 1 EHR player. We like to think of our whole team as leaders, in the skills and experience needed to implement what the DoD is trying to do. You have to be up for the challenge of a big, diverse delivery environment. The DOD is certainly setting aggressive timelines, but they are absolutely reasonable and doable. We've been preparing and seeding the work to make sure we are ready to go if we are fortunate enough to be chosen. This is a once in a lifetime opportunity and we all realize this.

Q: What is the dynamic like between/among your three companies?

Lydon Neumann: It's been very impressive to see this team collaborate. It's been equally impressive to see the DOD communicate. We are a team that brought three dimensions — Epic has the best software in the world, and IBM brings a global, scalable approach. We are also a team that internalized what it takes to successfully implement in the healthcare environment. We were attracted to the possibility of this. I would compliment both Epic and IBM in their ability to work with that.

AM: Beyond the three of us, we also bring DOD engineering and cyber experience beyond what IBM has, and that's why we have world class companies like Lockheed Martin and a diverse set of other partners that have implemented in DoD and have driven the kind of change management and transformation that will happen here. To put this together has been a great experience, but moreover our task has been to establish a highly trusting and innovative environment that exists ahead of the award, so we aren’t getting to know each other on Day 1. IBM, Impact Advisors and Epic are three of the main cornerstones, but there are many others who are behind it.

LK: Our team has had a longstanding relationship together in healthcare. We share many of the same customers. That has enhanced our relationships and moved that timeline up for us because we want to meet what the government wants. It's about advancing healthcare for the nation. The government has a vision for how these teams would come together, and a lot of people have doubted that it would be able to work, but for our team it has really brought us together to answer. The government needed to see us as one team.


Q: If you are awarded the contract, how will your solution adapt to the coming regulations and changes in healthcare over the next decade?

LK: I think we are constantly listening to our customers and the government. They want engagement and they want leading companies. They don't want to be an island. Access to our customers gives them a massive amount of information. The registries go on and on and on. Combine that with products like Watson and Epic's partnerships with Apple and the HealthKit platform. You put a company like Impact in, a leader in execution, and all of those things combined change us as an organization, but only for the better.

AM: When you do business with the DOD as IBM has for more than 100 years, the upcoming changes in the healthcare industry today are another chapter in the many evolutionary changes that have faced DoD over this period.. Regulations change. Laws change. Technologies change Structures change. You have to come to the table ready for that. I think that's why our team structure is designed to not be all EHR or new technology. It is about clinical transformation, change management, population health, lower costs, better outcomes. It has to be a blend.

LN: One of the things we advise our clients is that the implementation is not the end of the journey. A product's stability, how mature that product is, depends how you expand it or maintain it. This will be a very dynamic environment. This would give them the assurance that they are not playing catch-up and can build with other clients to optimize those products over time.


Q: How will the partnership react or change if your team is selected for the contract?

LK: We have a very active user group community that is built on foundational sharing. I think that the most fascinating thing is that our customers are world-class. They are driving our platform. The list of things they want us to do is very long. If the DOD joins that group and you think about clients driving a vendor's innovation, it is really exciting to think about where they're going to ask us to go. We're happy to be a part of that.

AM: For IBM this is a grand challenge that comes once in a decade, or once in a century. The DOD is a very special place with very special end customers and transforming care is about so much more than standards and technology. That’s why we’re testing capabilities with partners around the country so we can hit the ground running if we win contract. We think this program is inherently doable and we’ll be ready to go on day one should we be selected.

LN: Collectively, we're humbled by the opportunity. This is a very important project. I think the outcome will be rewarding for the DOD.

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