I recently wrote an article for Washington Technology on reforms in military
health IT and I thought I’d share some highlights with you. In case you didn’t know, the Department of Defense (DOD) consolidated much of its health IT responsibilities into the Defense Health Agency (DHA); which celebrated its first birthday on October 1st. My article explores several key opportunities stemming from this major overhaul of DOD’s outdated military health system.
The Defense Contract Management Agency (DCMA) released an RFI for Legacy System Modernization earlier this month with a quickly approaching August 4th response date. The RFI seeks to obtain modernization of the Mechanization of Contract Administration Services (MOCAS) system. The system, which dates back to the 1950s, is an enterprise solution that provides contract management and disbursement and management of funds. It is 65% owned by DCMA and 35% owned by the Defense Finance and Accounting Service (DFAS).
Health IT in the federal government represents a $6 billion market.
Let that number sink in. It may seem high, but recent guidance from the Food and Drug Administration (FDA) and the Office of the National Coordinator for Health IT (ONC) indicate that “health IT” as a concept means much more than just EHRs. According to the report, there are three broad categories of health IT:
Administrative health IT functions: This includes billing and claims processing, practice and inventory management, and scheduling.
Health management IT functions: This category includes health information and data exchange, data capture and encounter documentation, electronic access to clinical results, clinical decision support, knowledge management, and patient identification.
Medical device health IT functions: Examples include computer aided detection/diagnostic software, radiation treatment planning, and robotic surgical planning and control software – in other words, devices actively used in medical treatments.
With the unveiling of FY15 Budget requests this week, the news has been inundated with ominous (though not surprising) stories surrounding further reductions of forces within the DOD, terminations of modernization programs/acquisitions, retirement of aircraft, etc. The overall message is that DOD has been forced to stretch their resources in an increasingly complex threat environment.
One of the great tools we in the vendor community have is the Office of Management and Budget’s (OMB) IT Dashboard, which is a fantastic resource that provides us an additional layer of detail regarding agency’s IT budgets. The Dashboard was created as a way to display the Exhibit 300s that make up some of the key IT investments in the federal space, as well as providing us additional visibility on progress toward meeting OMB initiatives like the 2012 Digital Government Strategy. OMB has also used it to highlight at-risk government IT investments, of which there are quite a few.
Unfortunately, however, the IT Dashboard seems to go for months without being updated, and the lack of updates has now caught the eye of the Government Accountability Office (GAO). GAO found that over the last few years the IT Dashboard has been updated only 33% of the time instead of every month, which seems to be somewhat in opposition to the mission of transparency that was championed by the Obama Administration when the President first came in to office. As a result, vendors are on the outside looking in and aren’t able to quickly respond to these troubled programs, as they could do if the government was more transparent.
The U.S. Air Force is a vast and sprawling organization that relies heavily on technology due to its unique mission. The Air Force’s base budget request for FY14 is $114 billion – 4% higher than FY13’s request (although actual apportionment may differ, depending on the impending omnibus) and the IT budget request is roughly $5.5 billion. The Air Force will likely spend close to that – somewhere around $5.4 billion, which represents a 2% increase from FY13.
Unfortunately its organizational landscape can be complex and even confusing making it difficult to find out where key people and organizations controlling these purse strings reside. It’s important to remember that the Air Force component offices all have unique requirements gathered by representatives from the Air Staff or Air Force Secretariat for the benefit of shared systems that are leveraged across the department. These shared systems range from HR, financial, and logistics systems to those involving networks and infrastructure, operational command and control, as well as cybersecurity. Shared systems and investments such as DEAMS, IPPS, GCSS, and AFNET bring requirements together from multiple disparate component organizations, but are centrally managed.
by Lloyd McCoy Jr., Consultant
