The U.S. Department of State has released a request for information for a new electronic health record last week, stemming from a failed joint EHR implementation with the Coast Guard.
The Coast Guard had attempted to share a hosted EHR with the State Department, known as the Integrated Health Information System, or IHiS. But the agency terminated its contract with Epic in 2016 due to various system irregularities, increased costs and technical complexity.
At the time, Coast Guard officials determined there were significant risks to continuing IHiS and pulled out of its contract. The Coast Guard has been operating on paper records ever since. Although, officials put out an RFI for an EHR in 2017 to start a new project from scratch.
The State Department is now working on its own to implement an EHR, which would support the agency's healthcare program for its department and U.S. government employees serving abroad.
The agency is also looking for shared services capabilities with other federal agency EHRs, like the Department of Veterans Affairs and Department of Defense. Cost is also top-of-mind in the RFI, as is risk. Officials are also requesting information for a phased deliverable approach.
The Coast Guard's use of paper has been chastised by Congress and the Government Accountability Office – which called its program a "debacle" in January. Responses to the RFI were due May 2017, but so far there's been no movement.
DoD is currently in a planned assessment stage for its own Cerner EHR implementation. Roll-out to other agency sites should begin by late spring. As for the VA's EHR project: Without former VA Secretary Shulkin, it's uncertain when the contract with Cerner will be signed.
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