Coast Guard EHR: Round Two

Published: April 27, 2017

Electronic Health RecordHealth ITUSCG

The U.S Coast Guard released an RFI on April 23rd seeking information on sources capable of providing a computerized, integrated electronic health record solution for replacement of their current paper health records.

This is the Coast Guard’s second attempt at an EHR.  In 2010, they awarded a $14M contract to Epic Systems for implementation of a COTS EHR in their Medical Information System (MIS) environment.  In September 2012, they awarded a nearly $18M task order via the DHS Eagle contract vehicle to then SAIC, now Leidos, to help them implement the Epic solution and provide Integrated Health Information System (IHiS) service desk support.  According to Politico research, the Coast Guard relied on five separate vendors to build the new system and spent approximately $34M on health IT between 2010 and 2016.

A year ago, the Coast Guard decided to pull the plug on the original effort and revert back to paper health records. The system was never deployed to Coast Guard clinics or vessels.  After the Epic contract award, the Coast Guard began workflow analysis which lead to additional system requirements, causing a snowball effect.  The scope of the project changed and expanded, leading to multiple delays and challenges.  The Coast Guard’s own planning seemed to have been at fault.    

After the project cancellation last April, Lieutenant Commander Dave French, the Coast Guard's chief of media relations, told Healthcare IT News, "In 2015 the Coast Guard determined there were significant risks associated with continuing the IHiS project and decided not to exercise further contract options. The decision was driven by concerns about the project's ability to deliver a viable product in a reasonable period of time and at a reasonable cost.”

The new EHR RFI states that it is for market research purposes only. “A solicitation is not being issued at this time, and this notice shall not be construed as a commitment by the Government to issue a solicitation, nor does it restrict the Government to a particular acquisition approach.” 

The RFI denotes key performance parameters of the EHR solution must:

  1. Support military health care delivery across the full range of military operations.
  2. Be deployed and managed on USCG computing and communications networks, and comply with all applicable DoD, federal government, and health care industry standards.
  3. Effectively exchange information with the VA and DoD.
  4. Meet connectivity, latency and reliability requirements in the “Tactical Fixed Center” and “Tactical Mobile Center” environments described in the DISA Operational Environments Model.

Hopefully this time around USCG can learn from its past experience and craft a successful EHR solution. I’m sure they are closely watching DoD’s MHS Genesis implementation and are highly interested in the outcome of VA’s decision about its own EHR direction.  Advanced planning, a thorough requirements analysis and needs assessment, along with a qualified systems integrator to guide the entire effort should garner positive results this time around.