Where the DOD contract falls short: Thoughts from athenahealth

"The DOD cannot achieve 21st century results with 20th century technology."

The Department of Defense surprised much of the healthcare IT world when it awarded bid team Cerner, Leidos and Accenture a multibillion dollar contract to overhaul the military health system's electronic records. The Defense Healthcare Management System Modernization project will update the military's record system and make it interoperable, which remains a concern even following the DOD's decision.

Not only do the medical records need to be interoperable within the military health systems, such as the Veterans Affairs (which operates on its homegrown VistA platform), but the DOD's solution also must interoperate with private systems, as many military servicemen and women seek care outside of military healthcare settings.

Many expected the team fielded by Epic, IBM and Impact Advisors to walk away with the contract, also beating the third team in the running comprised of Allscripts, Computer Science and Hewlett-Packard. Despite Epic's reputation for not being interoperable, the Verona, Wis.-based vendor does hold a significant market share of the country's health records, including big name systems like Oakland, Calif.-based Kaiser Permanente and Rochester, Minn.-based Mayo Clinic.

So when Cerner's team was announced, many reacted with surprise, including leaders at athenahealth.

"My first reaction was the same as a lot of people. 'Wow,'" says Dan Haley, vice president of government affairs at athenahealth. "Speaking for myself only (i.e. not on behalf of athenahealth), I expected the DOD to go with Epic, simply because the agency is notoriously conservative and that was viewed — rightly or not — as the 'safe' choice."

Interestingly, athenahealth works closely with Cerner on interoperability efforts, most notably the CommonWell Alliance, which the two vendors cofounded. Mr. Haley says while athenahealth's comments about the bid and the procurement criteria remain true, athenahealth is glad Cerner was the final recipient. Although he was surprised at the decision, Mr. Haley says it was a pleasant surprise.

"Cerner has demonstrated with us both via CommonWell and more generally they are philosophically dedicated to evolving to an open platform. We think that's the good thing," he says.

The DOD's criteria for consideration
In a press conference, Frank Kendall, a weapons buyer for the Pentagon, said, "There's a clear 'best-value' solution here for us" with the Cerner bid, according to a Bloomberg report.

athenahealth views things differently.

In a prepared statement, Mr. Haley voiced concern regarding the interoperable capabilities of the selected bid and the DOD's criteria in general.

"The DOD cannot achieve 21st century results with 20th century technology. Unfortunately, this award will set the country back in our collective quest to achieve in healthcare the same level of information fluidity that we take for granted everywhere else in the information economy."

The key issue with the procurement process, according to Mr. Haley, is the DOD's gating criteria for consideration. He found it highly prohibitive to many vendors.

"One of the gating criteria was the ability to provide a best-of-suite solution, which our procurement attorneys told us in no uncertain terms means…a static software solution," Mr. Haley says. "That precludes cloud-based players from even being considered."

athenahealth is one of those cloud-based players. Had the gating criteria been different, athenahealth would have strongly considered a bid for the contract. And, if interoperability is the goal, Mr. Haley suggests the types of solutions the DOD sought are on their way to becoming obsolete.

"They wrote a request for proposals that very literally precludes cloud-based technology from participation. In 2015, that just doesn't make sense if your goal is actually achieving interoperation. It's like doing telecom procurement and excluding telephones," Mr. Haley says.

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