- The United States Department of State is the latest federal agency considering a commercial EHR implementation.
Earlier this month, the federal agency posted a request for information on EHR project management support services although it remains non-committal about whether the State Department will pursue an agency-wide EHR implementation.
"This RFI is for planning purposes only," the notice states. "This is not a pre-solicitation or solicitation announcement and no contract will be awarded from this notice. The purpose of this RFI is to gain knowledge of the interest, capabilities and qualifications from the industry that can be used to satisfy the Project Management Support Services (PMSS) requirements."
As noted in the RFI, the State Department's Office of Medical Services (MED) provides medical services for employees and their families as part of more than 200 diplomatic missions in approximately 170 countries.
As for its health IT infrastructure, it varies by location:
MED's use of information technology currently includes deployment of an electronic medical record (EMR) system in limited locations for the adjudication of medical clearances for personnel being assigned abroad. MED also has implemented electronic prescribing, and has a robust system for managing scanned medical documents. Telemedicine is also widely used to support MED's overseas operations.
Posted on June 3, respondents have until June 16 to submit feedback on related to the potential global deployment of an EHR system:
MED is interested in information about specific capabilities from businesses that provide Project Management Support Services (PMSS) through all phases of the EHR project life cycle. This includes, but is not limited to, initiation and planning, execution, monitoring and controlling, training, implementation, go-live support and close out of the EHR system.
The State Department RFI comes as two of its sister agencies, the Departments of Defense and Veterans Affairs, face criticism related to EHR implementation, replacement, and optimization.
Recently, Representatives Will Hurd (R-TX) and Robin Kelly (D-IL) of the Committee on Oversight and Government Reform Subcommittee on Information Technology wrote the Government Accountability Office asking for a study of VA's EHR modernization project.
"In particular, we would like to receive information on the history of VA's efforts to modernize VistA, including the costs and results of the efforts, the key contractors that have been involved, and the work that these contractors performed," their letter stated. "In addition, we ask that the study determine VA's current plans and estimated costs for modernizing VistA."
The request for a GAO study followed a criticism of VA's previous work on EHR optimization in concert with DoD on the abandoned joint integrated EHR (iEHR) and by itself on the VistA Evolution following DoD's decision to seek a commercial EHR replacement to its AHLTA EHR.
That commercial EHR replacement project at DoD, likewise, has drawn attention after DoD's Office of Inspector General published an audit report raising doubts about the federal agency's ability to meet the end-of-the-year goal for its EHR implementation.
Based on its audit of the DoD Healthcare Management System Modernization (DHMSM) program, the IG conclude that the project's timeline "may not be realistic" for a number of reasons:
While the DHMSM program office has identified risks and mitigation strategies, it is still at risk for obtaining an EHR system by the December 2016 initial operational capability date because of the risks and potential delays involved in developing and testing the interfaces needed to interact with legacy systems, ensuring the system is secure against cyber attacks, and ensuring the fielded system works correctly and that users are properly trained.
Despite the warning, DoD officials remained confident in the goal set for later this year.