- The Coast Guard should seriously consider implementing a Cerner EHR system to mirror that of the Department of Defense (DoD) and VA, according to testimony from GAO Director of Information Technology Management Issues David Powner at a recent subcommittee hearing of the House Transportation and Infrastructure Committee.
The hearing came after the public release of a Government Accountability Office (GAO) report about the Coast Guard’s decision to terminate its Integrated Health Information System (IHiS) project in 2015. The Coast Guard initially awarded the contract for IHiS to Epic, but ultimately cancelled the project and decommissioned the two legacy EHR systems IHiS was meant to replace.
As a result of these failed attempts to implement an EHR system, Coast Guard clinics reverted to manually maintaining mostly paper-based patient health records.
“Coast Guard Regional Managers and clinic and sick bay administrators informed GAO of the many challenges encountered in returning to a paper process,” stated GAO in its report. “These challenges include the inability for some clinics to adequately track vital information such as the medications members are taking—potentially causing harm to them.”
Though the Coast Guard has run up against several challenges as a result of reverting to paper records — including incomplete records and appointment scheduling problems — the department has still not made a final determination about an EHR replacement for IHiS.
In addition to causing administrative problems for Coast Guard care sites, the failed IHiS implementation project also wasted nearly $60 million in spending over about 7 years. None of the software or equipment developed during the life of the project can be reused for future efforts.
GAO recommended the Coast Guard swiftly acquire a new EHR system, ensure key processes are implemented, establish project governance boards, and document lessons learned from its failed Epic implementation in 2015.
At the subcommittee hearing on January 30, Powner more pointedly suggested the department pursue the Cerner EHR solution being implemented by DoD and VA.
Representative and Chairman of the Coast Guard and Maritime Transportation Subcommittee Duncan Hunter (R-CA) also urged that the department partner with DoD and VA to implement a Cerner EHR system.
“Why not save all that money and time and be efficient and use DoD’s product?” said Hunter.
While the Coast Guard has not made a final determination in its EHR replacement process, the Cerner system is certainly on its radar.
“The Coast Guard is looking with great interest at what DoD is doing and what VA is doing with their new electronic health record system,” said Rear Admiral and Coast Guard Director of Health, Safety, and Work-Life Erica Schwartz.
“As a military service we certainly are looking at what they are doing with respect to the new MHS Genesis product, and what are doing is looking at what their lessons learned are,” she continued.
Hunter maintained looking at other EHR product offerings from different vendors is a waste of time and money and suggested the Coast Guard end their search for a new EHR replacement by adopting a Cerner system akin to that of DoD.
“We are working with VA and DoD to make that happen,” said Rear Admiral and Coast Guard Chief Acquisition Officer Michael Haycock.
Representative and Coast Guard Subcommittee Ranking Member John Garamendi (D-CA) also recommended the Coast Guard adopt a similar system to VA and DoD to ensure interoperability between departments.
While making a sound EHR replacement decision will be imperative to ensuring the Coast Guard does not repeat its past mistakes with IHiS, Powner ultimately stressed putting capable executives in charge of the project as his key recommendation.
“You can have the best project management on these technology projects, but if you don’t have executives that are accountable and breathing down the necks of project managers — that’s what makes this stuff work,” Powner said.
Haycock admitted IHiS did not have the appropriate oversight, but maintained the current executives in charge of the EHR acquisition are equipped to carry out the project successfully.
“IHiS was a watershed event,” said Haycock. “It shook our foundations and really caused us to sit back on our heels and try to figure out what happened.”