New EHR contract awarded

[Monty Python]

New EHR contract.

http://www.modernhealthcare.com/article/20150729/NEWS/150729824

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[pgg]

The total cost of ownership of the system over its projected 18-year life cycle, once estimated at $11 billion, “we think now it will be $9 billion,” said Frank Kendall, undersecretary of defense for acquisition, technology and logistics.

However, only one-third of the contract will be for a fixed amount, he said. The rest will be on a “cost plus” basis.

*cough*

 

[Perrotfish]

Awesome!

 

[Gastrapathy]

They picked Cerner over Epic. Terrible choice. I use both on a near daily basis and Cerner is clearly inferior. The "powerplans" and note templates are nowhere near as efficient. This was politics and lobbying at its worst. Guess I shouldn't be surprised.

 

[Perrotfish]

They picked Cerner over Epic. Terrible choice. I use both on a near daily basis and Cerner is clearly inferior. The "powerplans" and note templates are nowhere near as efficient. This was politics and lobbying at its worst. Guess I shouldn't be surprised.

I have used both and thought they were pretty comperable. Also it sounds the the concerns from Epic were price point and its interoperability with non Epic EMRs, neother of which I could speak to.

Anyway the point is they managed to successfully select a real EMR that is good enough that major hospitals across the nation have seen fit to use it. No obscure new system no one has ever heard of that lobbied its way into existence. No lowest bidder system that is too low quality for major hospitals to use. No 'we couldn't do it' and 10 more years of AHLTA. Even if this isn't your top choice this is clearly a good EMR.

Can we please be happy about this? At least for a day or two?

 

[backrow]

Can we please be happy about this? At least for a day or two?

a seven year roll-out....I'm happy that I'm not in the Pacific NW where the article said was going to be first. Does that count?

 

[WhatUpDoc!]

I have used both and thought they were pretty comperable. Also it sounds the the concerns from Epic were price point and its interoperability with non Epic EMRs, neother of which I could speak to.

Anyway the point is they managed to successfully select a real EMR that is good enough that major hospitals across the nation have seen fit to use it. No obscure new system no one has ever heard of that lobbied its way into existence. No lowest bidder system that is too low quality for major hospitals to use. No 'we couldn't do it' and 10 more years of AHLTA. Even if this isn't your top choice this is clearly a good EMR.

Can we please be happy about this? At least for a day or two?

I'm certainly excited about it because in all actuality, paper charting is a step above AHLTA. I used Cerner throughout med school and Epic in residency. And by far, Epic is superior, but Cerner is light years ahead of AHLTA when it comes to functionality and overall user-friendliness. I was a little surprised that the article mentioned Epic has problems with interoperability because the "Epic CareEverywhere" system worked great to electronically transfer records from other hospitals when I needed to do so in residency. Oh well, at least better days are ahead and the dreaded Tier 1 error screens will be gone soon enough!

 

[Gastrapathy]

I have used both and thought they were pretty comperable. Also it sounds the the concerns from Epic were price point and its interoperability with non Epic EMRs, neother of which I could speak to.

Anyway the point is they managed to successfully select a real EMR that is good enough that major hospitals across the nation have seen fit to use it. No obscure new system no one has ever heard of that lobbied its way into existence. No lowest bidder system that is too low quality for major hospitals to use. No 'we couldn't do it' and 10 more years of AHLTA. Even if this isn't your top choice this is clearly a good EMR.

Can we please be happy about this? At least for a day or two?

Did you use them in the outpatient setting? That is where Cerner really falls off IMO. You want to be happy about picking the second best, go for it but you can see in the article that the powers that be attacked Epic to ensure Cerner's selection. I wonder why...

Maybe because Epic didn't partner with SAIC (Thats right, the winning bid was made by the company that brought you, wait for it...yup CHCS). Did you see what happened to Cerner's stock price yesterday even though the decision was secret? Someone made a fortune.

Just remember the thousandth time you hit that little refresh button and try to figure out what medications your patient is actually written for, you could be home by now.

 

[j4pac]

I was rooting for paper charts. EMRs have made it too convenient for administrators to data mine and determine quality of care by looking at a bunch of numbers. Instead of patient care you are more focused on creating smoke and mirrors to make the numbers look good. It is actually a joke.

With all that said...anything is better than AHLTA...so yay!

 

[HighPriest]

I want to say that anything is better than AHLTA. But I feel like AHLTA is out Sadaam Heussein, and we're getting ready to distribute some freedom that will ultimately crumble into anarchy and conflict.
Undoubtedly, the transition period will be utter chaos for many months. That would probably still be worth it if they use the EMR like a civilian facility might. Yes, it takes a long time to populate meds, but so does AHLTA, so that point is kind of a break even. However, I would bet money on the DoD packing Cerner so full of DoD-exclusive requirements and add-ons that they'll kill it. It'll be an overloaded pack animal wishing for death.

I just....don't trust the DoD with anything. They're like a semi-******ed, sociopathic, pyromaniac child who loves puppies but mostly loves the way that they look on the inside...

 

[pgg]

They picked Cerner over Epic. Terrible choice. I use both on a near daily basis and Cerner is clearly inferior. The "powerplans" and note templates are nowhere near as efficient. This was politics and lobbying at its worst. Guess I shouldn't be surprised.

Anything is better than that abomination AHLTA.

I'm a bottomless well of snark and sarcasm regarding the cost projections, but replacing the chemical spill train wreck we've got is a very good thing.

 

[Gastrapathy]

Anything is better than AHLTA. But for billions of dollars, that shouldn't be the standard.

Cerner is fine. It's just a clear 2nd best.

 

[didja]

Epic and Cerner both are poor EMRs in my opinion. Just because they are commonly used and are better than AHLTA doesn't make them strong EMRs. I always chuckle when I get recruiting postcards and "Epic EMR" is listed as a reason to select their practice over others.

Almost no one size fits all program works well for everyone. One of the benefits will be finally putting chcs out of its misery.

 

[StevenRF]

Was hoping for EPIC as well. Do they plan to integrate all of the other systems (CHCS, HAIMS, ASIMS, AIMWTS, PEPP, Esentris, imaging, I'm forgetting a few...) and legacy paperwork forms?

 

[Gastrapathy]

Epic and Cerner both are poor EMRs in my opinion. Just because they are commonly used and are better than AHLTA doesn't make them strong EMRs. I always chuckle when I get recruiting postcards and "Epic EMR" is listed as a reason to select their practice over others.

Almost no one size fits all program works well for everyone. One of the benefits will be finally putting chcs out of its misery.

What EMR is better?

 

[Apollyon]

What EMR is better?

As I have said many a time, "It's not which one is best - it's which one sucks the least."

 

[didja]

One size fits all answers are poor. For derm, the EMA app is outstanding (because it really lets your support staff help you and for it's "grand rounds" feature that lets you see other user's prescriptions). I'm sure a civilian ENT, FP, pediatrician and urologist would each have their own favorites suited to their needs (maybe Epic or cerner would some of their favorites).

Just because these are widely used EMRs doesn't mean they were even close to the best choices.

 

[Gastrapathy]

That's a simplistic view. A derm EMR? That's easy. So what. They are right to demand one system.

What systemwide EMR is better?

 

[didja]

Actually, a modified VA system with its associated mail-order system would have been a candidate, if only to save me and fellow taxpayers 9-14 billion $.

Again, it shows the sorry state of EMRs that docs have been trained to think that cerner/ epic are good products.

 

[Shikima]

I'll disagree that EPIC is poor. You can custom the scripting and import documents from other sources to be apart of the record compared to other, current, EHRs which are being used. This include the VA's system which is based on Dos 3.1. Ok, maybe not that bad, but it does offer some ability to customize the flow of the note but it is hard to import outside data into notes. All other EHRs that I've seen cannot allow for this function.

 

[j4pac]

We need an EMR with an adaptable interface. Technology is outpacing our EMRs...that's the problem. The current EMR we are bringing in will be obsolete within a few years...just like AHLTA currently is. We need a support system with TRUE updates to our EMR.

 

[didja]

Yep, this. Any one size fits all setup is going to be poor and as long as the systems let the notes get compiled it shouldn't matter if derm, ent, emer med, etc are using different systems. Does anyone really think ophthalmology will actually be "using" the new emr? They'll be scanning their notes onto the bottom of useless place holder progress notes like always.

Also, even horrific AHLTA has Haims scanning, templates and order sets (can't believe I'm being forced to compliment AHLTA in this thread). Epic had a hard time scaling itself to Kaiser when it was deployed for them in 2005 (I suspect these troubles were part of why Cerner got the contract actually ). I wasn't part of any of the decision process but am civilian trained and worked with all these systems and I didn't come out a big fan of epic.

 

[omn]

So, as an M.B.A. and now with an M.D. and, um, let's call it "government consulting" experience (for us older folks who know it's "outsourcing" (what happened to Arthur Anderson, Arther D. Little, Monitor, and Bearing Point, BTW) can I apply to Accenture to work? Do they have a job portal? Would that work..? I still remember exactly where I was the day I learned that Ross Perot became a billionaire computerizing Medicare and Medicaid.. little known fact that the news media never covered covered (but as Goljan would say.. "Why?... Why?) .. maybe I didn't follow that.. the 1992 election.. I guess I was only Political Economy student in Britain... at 24... (but kind of a strange background for someone so against centralized government...)

 

[Monty Python]

1. I have no EHR experience other than with the systems used by Uncle Sam. Does anyone with Cerner experience know if the anesthesia chart is already contained within the system? If not, how is the anesthesia record imported? Assuming one exists, is the Cerner electronic anesthesia record contained in a hand-held tablet which relies on manual entries, or in hardware physically attached to the anesthesia machine/monitors and automatically charted?

2. The electronic anesthesia charting system currently used by .milmed, "Innovian," is manually uploaded into Essentris as an imported .pdf. Note: all of our anesthesia machines are GE. Anyone know if Innovian slaved to a Drager automatically imports into Essentris?

 

[psychbender]

2. The electronic anesthesia charting system currently used by .milmed, "Innovian," is manually uploaded into Essentris as an imported .pdf. Note: all of our anesthesia machines are GE. Anyone know if Innovian slaved to a Drager automatically imports into Essentris?

Nope, we have Dragers, and still manually import our records into Essentris as .pdfs.