7 keys to DOD's huge health opportunity

Almost one year ago the Defense Department completed the biggest overhaul of its sprawling military health system ever, highlighted by the creation of the Defense Health Agency.

While the military departments still have their respective medical commands, DHA brings together under one roof functions such as health IT. The massive reorganization comes after eight previously failed attempts to unify the sprawling defense health complex spanning over 1,200 locations and 10 million beneficiaries.

As DHA nears its first anniversary, all indications point to an agency slowly coming into its own. That’s because DOD didn’t stop at changing the organization charts and legacy responsibilities. Some of the biggest health IT projects the military has ever seen are taking place over the next few years and DHA is in the middle of what’s happening.

So where will these investments be?

REPLACING THE EHR SYSTEM

First and foremost is the upcoming rip and replace of its legacy electronic health record systems. This will be a 10-year IDIQ worth $11 billion.

Teams composed of Cerner/Accenture/Leidos, Allscripts/HP/CSC and IBM/Epic Systems have all announced their intention to bid for the contact, which will likely be awarded next spring and begin deploying in December 2015.
The winning team will need a lot of help as requirements will involve a wide range of technologies especially identity management, security, visualization, and analytics. All signs point to DHA directly managing this effort after the contract is awarded.

Another initiative and one unbeknownst to many is DHA’s upcoming efforts to consolidate its internal infrastructure to improve health related information sharing and management.

A major aspect of this plan will be a standardized desktop that will deliver and sustain a common baseline across the Military Health System for both traditional and virtual desktops. The non-standard, decentralized desktop environment is hard to manage, expensive, less secure and inflexible, causing a negative impact on health care providers’ ability to do their jobs. This standardization will focus on release management, software licensing, hardware, data storage, and refresh strategies. 

DHA will also consolidate its local and wide area networks to connect users to local and enterprise applications, network peripherals, network drives, and the internet/intranet under a single security architecture. 

These and other initiatives point to a standardized approach for regionally storing data and delivering applications and services in close proximity to the point of care or need. DHA’s goals efforts point to the core of the DOD medical’s inability to effectively share information, manage, and deliver standard business and clinical capabilities to providers throughout the Military Health System.

Improving availability and timeliness will save lives.

SUCCESSFUL SELLING

The last 18 months have not been kind. The debacle over the integrated VA-DOD electronic health record effort and the more recent, but more troubling, delays within VA’s system have put military health in an unfavorable light.

DHA has a mandate to, where applicable and possible, use technology to improve the timeliness, access, and quality of health. Also, with healthcare costs amounting to about 10 percent of DOD’s half a trillion dollar budget, the current rate of spending is unsustainable. Consequently, DHA leaders have been charged to find savings wherever possible. 

It’s also important to know that DHA buys IT for the military health system. That is, not just DOD-wide systems and applications, but it is also chartered to address the needs of the service medical commands of which there are three: the Navy’s Bureau of Medicine and Surgery, Army Medical Department, and the Air Force Medical Service.

Finding success within military health requires understanding the unique needs within each service environment. For example, some sailors will receive approximately 70 percent of their primary care onboard ships and there are significant bandwidth and mobility issues for soldiers deployed in remote locations.

Complicating the job of DHA are the multiple existing networks which not only result in redundant operations and maintenance but often constrain access to systems and information. DHA needs help. Industry has a once in a lifetime opportunity to help shape the future of military medicine. 

It’s sounds like a cliche to say that technology saves lives. In this case, it’s true! What resonates with DOD health leaders when it comes to technical solutions? How do you synch your message with what DHA and all military health entities want and need? Here are some recommendations:

• Focus on strategic IT infrastructure initiatives that support improved clinical care
• Identify consolidation and rationalization opportunities
• Recognize cost savings for critical infrastructure initiatives
• Goal is to have clinical locations across the globe possess the same IT functionality
• Understand that data must be aligned to national standards
• Come armed with ways to improve infrastructure and performance monitoring
• Increase access to interoperability tools