Chuck Hagel and the Secret War Over DOD & VA Electronic Health Records

The Defense Department is poised to issue a final request for proposals later this month for an $11 billion contract to replace its outdated electronic health record system and provide urgently needed improvements in the data-sharing capabilities between DOD and the Department of Veterans Affairs.

The two agencies have spent the better part of the last decade trying to improve interoperability between their distinct electronic health records infrastructures. Between 2011 and 2013 alone, they spent more than half a billion dollars on an effort to develop a new joint-integrated EHR that could serve military personnel from enlistment through retirement and veteran status, only to see extreme bureaucratic infighting and turf battles derail the project.

Today, the agencies are moving down separate modernization paths, with DOD working on its Defense Healthcare Management System Modernization program (DHMSM) and VA planning commercial acquisitions for the next generation of its Veterans Integrated System Technology Architecture, known as VistA. But analysts, including one of the founding developers of VistA, point to years of missed opportunities for DOD to leverage what many consider to be superior existing capabilities in VA’s VistA system — an ecosystem of modular application components that in most cases have become industry standards (VA’s troubled scheduling system notwithstanding).