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FCW : March 15, 2015
HEALTH IT One consolidation now underway involves centralizing computer network operations for medical facilities. The Army and Navy use DHA networks while the Air Force maintains its own structure. That is a manifestation of a larger cultural difference, Bowen said. “The Air Force is a lot more decentralized, and the base commanders have a lot more leeway,” he said. “You’ve got more centralized, standardized management in the Army and in the Navy. [Eventually,] we’re going to end up pulling the Air Force facilities off the Air Force network and consolidate them on our medical network.” Infrastructure consolidation is a big part of DHA’s work in fiscal 2015. The agency just finished moving MHS to the email system operated by the Defense Information Systems Agency. Bowen and his colleagues are also consolidating multiple help desks into a single global service center. So far, the consolidation is saving money: In fiscal 2014, DHA reported net savings of $236 million, with health IT contributing $39.19 million in savings. “In many areas, you have three chunks of infrastructure [and] three sets of applications, and so our job is to bring a lot of this together and drive operating efficiencies and dollars out of the operation,” he said. EHRs and the cloud The EHR project intersects with one of the Pentagon’s most high-profile IT initiatives. It will operate on the Joint Information Environment (JIE) network, which is still a work in progress and will offer “end- to-end information sharing and interdependent enterprise services across the department that are seamless, interoperable, efficient, and responsive to joint and coalition warfighter requirements,” according to budget documents. “We’re the tip of the spear for JIE now because we’ve got some pretty near-term objectives we’ve got to achieve,” Bowen said. “We’re work- ing with [DOD CIO Terry] Halvorsen’s office to make that happen.” However, there are some question marks when it comes to data cen- ters and cloud services. DHA will be bound by DOD cloud policy, still under development, when evaluating proposed enterprise hosting strategies for DHMSM. But the contract doesn’t include enterprisewide or Tier 1 host- ing services for DOD data centers and approved commercial hosting facilities. Instead, the contractor is responsible for proposing a network and infrastructure solution that cor- responds to the requirements outlined in the solicitation. The government plans to procure enterprisewide services separately, “based on the footprint proposed by the DHMSM contractor,” a Pentagon spokesperson told FCW. “The govern- ment anticipates that proposed system architectures may range from a cen- trally hosted to a regionally deployed solution based on the proposed EHR system’s ability to scale functionally, geographically and administratively.” That gives DOD time to refine its still evolving cloud strategy in the event that the EHR system involves commercial cloud providers. But on the ground, where the records are being used, DHA is standardizing the technology. “We’re going to be looking at basical- ly managing what we call ‘data center to desktop,’” Bowen said. “This is new for us. This is something we haven’t done in the past. The facilities have been allowed to manage their own medical infrastructure however they so choose.” The EHR system will undergo a testing period in military health cen- ters in the Pacific Northwest in 2016 before opening up to the entire mili- tary. “We’ve had teams out there the last couple weeks looking at the infra- structure,” Bowen said. “We had a sym- posium on that and the findings last week. Our near-term objective is to have that infrastructure in place and operational [in the Pacific Northwest] by the end of calendar year 2015.” By government standards, the DHMSM procurement appears to be on schedule. Bowen credits the inte- gration of the teams that are sharing in implementation. There are monthly progress meetings with Undersecretary of Defense Frank Kendall, the project managers, DHA officials and the sur- geons general of the military services. “Obviously, it’s a very visible project. It’s a very expensive project,” Bowen said. “I think it’s a credit to our orga- nization and the fact that DOD does have a lot of these project manage- ment skills that they can bring to the table. You may have a contract- ing glitch or something like that, but given all the resources that we’ve got on here, we’re still running the way we should be running.” n “We’re the tip of the spear for JIE now because we’ve got some pretty near-term objectives we’ve got to achieve.” 22 March 15, 2015 FCW.COM 0315fcw_020-022.indd 22 2/23/15 3:44 PM
March 30, 2015