Wednesday’s news that the team of Cerner, Leidos and Accenture Federal had won the Defense Healthcare Management System Modernization contract to replace the Department of Defense’s electronic health records system came as a bit of a surprise, as many had assumed Epic Systems and IBM were shoo-ins.
The contract award also drew strong reactions, including skepticism, from across the health IT industry. The primary criticism, expressed in several mainstream media stories in the days leading up the announcement, was that the Pentagon was choosing between finalists that all offer clunky, old-school, client-server technology that would end up costing taxpayers more than it should.
(Interestingly, the total cost estimate came in at about $9 billion, according to Military Health System officials, well below the previously stated figure of $11 billion. The initial work is worth $4.3 billion over two years, but the contract is renewable.)
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Competing vendors mostly kept quiet about the award, but not athenahealth, maker of cloud-based EHR technology. Within 35 minutes of the DoD’s announcement, the Watertown, Mass.-based company sent two statements to the press.
From Dan Haley, athenahealth’s vice president of government affairs:
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.
Athenahealth CEO Jonathan Bush, not known for holding back, had a longer critique:
A year ago when the DoD opened its competition for its $11B digital health contract, it spurred national dialogue on how best to connect care across the U.S. As nearly every American can attest, healthcare has struggled more than any other industry to move information to and from where it ought to go. The opportunity that came with the DoD contract was to build a national health information network that could ensure patients’ health information could follow them no matter where they went: a VA hospital, a tent in a war zone, a retail clinic or standing in line for coffee while checking a prescription via a mobile patient portal. Given the DoD’s decision, I’m not optimistic we’ll see this. Healthcare, just like every other industry, could operate better and more effectively if backed by more open, Internet-based platforms that are tied to results vs. traditional, pre-Internet software. By partnering with the very same legacy HIT system vendors who are largely responsible for the current state of disconnected health care, the DoD is making a long slog toward the type of interoperable infrastructure the ONC mapped out in its 10-year plan. I hope I’m wrong.
Then the tweets started flowing.
One of the first to opine was the first person to lead the Office of the National Coordinator for Health Information Technology. He was far from critical.
Congratulations to Cerner. The right company won! @Cerner @NealPatterson
— David J. Brailer, MD, PhD (@DavidBrailer) July 29, 2015
Someone with connections to Epic wasn’t so praiseworthy. He also hinted that Leidos, Cerner and Accenture may have underbid IBM and Epic.
Fellow Epic consultants, employees, admins, etc, work even harder and let's show @DeptofDefense they made a colossal mistake #DHMSM
— Stephen Fiehler (@SFiehler) July 30, 2015
.@DeptofDefense can pay $1 trillion on useless F-35 fighter program but can't pay an extra $2 billion to give soldiers the best EMR #DHMSM
— Stephen Fiehler (@SFiehler) July 30, 2015
A parody of Epic CEO Judy Faulkner made the same insinuation.
What's to say? The DoD got cold feet and they chose an inferior system on price. God help our people in uniform https://t.co/JyFFqyjOVD
— Fake Judy Faulkner (@FakeEpicJudy) July 30, 2015
This person thought that Cerner’s win of a DoD laboratory information systems contract earlier this month was prescient.
@Cerner wins the DoD bid for EMR. Writing was on the wall 2 weeks ago with the @Army bid coming in for lab. #HIT #EMR #CERNER #DHMSM
— Josh Bittman (@HealthcareJosh) July 29, 2015
The work ahead will not be easy, according to this tweet.
https://twitter.com/MHVChampion/status/626789893793050624
John Caucis is an analyst for research firm Technology Business Research Inc. He seems to think the losing bidders, also including the team of Allscripts Healthcare Solutions, Computer Sciences Corp. and Hewlett-Packard, in addition to the Epic-IBM partnership, might challenge the decision.
https://twitter.com/jcaucistbr/status/626514116862193664
An anonymous Allscripts critic suggested that Allscripts never had a chance because that company uses a lot of overseas programmers and customer-support representatives.
https://twitter.com/AllScriptsTruth/status/626548958450597888
https://twitter.com/AllScriptsTruth/status/626552026634321921
However, they are celebrating in Kansas City.
High-five to my #Cerner friends. You earned the honor of improving health care for our #military. Keep making #KC proud.
— Kate O'Neill Rauber (@korauber) July 30, 2015
Yes, Cerner Chairman and CEO Neal Patterson and Vice-Chairman Cliff Illig are part of the ownership group of the Sporting Kansas City soccer team.
You think when SKC has a particularly bad loss that Cliff invites the guys over to swim in his vault of 4.3 billion gold coins? #cerner
— Karah Marshall (@KarahM318) July 30, 2015
And one jokester played off the DHMSM acronym, pronounced “dim sum.”
Crazy that this place is doing $4.5 billion of business tonight. #dhmsm pic.twitter.com/99cdIJRtb2
— Dan Diamond (@ddiamond) July 30, 2015
Photo: Flickr user Toni Blay