Defense Health Agency comes into shape through IT shared services

Wednesday - 1/8/2014, 1:20pm EST

Dave Bowen, director of health care IT & CIO, Defense Health Agency

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Editor's Note: Dave Bowen, the director of health care IT and CIO of the Defense Health Agency, will join Federal News Radio's Jason Miller for a live online chat Monday, Jan. 13, at 1 p.m.

Registration for this free event is required. Pre-registration is now open and will continue through Friday, Jan. 10, at 4 p.m. REGISTER NOW FOR FREE.


The new Defense Health Agency's ability to merge several different technology platforms is as much an anthropological effort as it is a technology puzzle. DHA's IT staff eventually will be more than 8,000 strong and will rely heavily on shared services to meet its mission.

Dave Bowen, the director of health care IT and chief information officer for DHA, said his job, in part, is to bring the three-month-old organization together.

Bowen said DHA focused on five shared services initially for the October launch: medical logistics, facilities capabilities, health plan operations, IT and pharmacy. "We basically were asked to develop a business case around how we would consolidate the military healthcare resources within IT and the other services within a shared services model as well, and provide that on a services basis back to the services," Bowen said. "What we are doing is consolidating like operations. Certainly, these five I mentioned have big dollars flowing through them. They are very important. Some of the efforts in terms of benefits of putting them together in some areas certainly are longer term than in other areas. Certainly with facilities, we eventually will be looking at standardizing what our facilities look like, how they are designed, constructed, things like that. That's a longer term issue. But certainly in other areas like pharmacy and IT, we have the ability to recognize some pretty short-term savings and some significant savings as we move forward further down the road."

In 2011, an internal task force analyzed the structure of and possible options to improve the of the Defense Department's military health system. In March 2013, then-Defense Deputy Secretary Ash Carter signed off on the memo establishing the DHA's structure. DHA incorporated the TRICARE Management Activity and the Joint Task Force National Capital Region Medical, and eventually will provide a host of back-office services for most of the services medical needs.

FOC by 2015

Bowen is in charge of the IT portion of those shared services. He said on Oct. 1 about 750 government and military employees and 1,000 contractors moved into DHA's IT shop. He expects the DHA IT shop to reach full operating capability in October 2015 when all the facility and regional IT employees will join the organization on a full-time basis. DHA's IT budget is about $2 billion to cover about 56 hospitals, about 350 clinics and 9.6 million members in the military's health plan.

"The DHA basically was stood up to be an operating arm of the assistant secretary of Health Affairs, which will basically remain in place as more of a policy organization. We are very much an operating entity," he said. "We have a number of divisions in the HIT organization. We have an innovations group, a governance and customer relations group; we have an infrastructure and operations group, solutions delivery, security and privacy. We also have two organizations that are relatively new adds that support our existing applications, one on the business side and one on the clinical side."

Bowen said he has three major priorities for DHA.

The first is completing the initial operating capability of the agency around IT.

Bowen said the second priority is to meet those savings objectives by making the right investments.

"We designed the organization and the business case around standing it up, we did run numbers around savings and efficiencies we thought we could gain from the consolidation," he said. "Obviously, we have a good deal of duplication in terms of hardware, software, infrastructure and things like that. We did a lot of work around what we could save from consolidating that. Over the next five years, we have savings initiatives in three years. One is the consolidation of management and that includes some of contracting activities and bringing all the contracts together. The second area is around consolidation of our infrastructure. The third area is the consolidation of our applications, what we call portfolio rationalization."

22 e-learning systems

For example, DHA is reviewing its e-learning systems and found about 22 different applications that could be consolidated down to a few. Another ripe area is around data centers, help desks and networks.

Bowen said one of their early goals is to transition multiple email systems to the enterprise email system run by the Defense Information Systems Agency in the cloud.

"As we looked at some of our contracts, we found some of our contracts were half used so we have some contract savings there," he added.

The third priority is ensuring the continuity of operations during the transition. He said the military service's surgeon generals were concerned about the impact of healthcare services during the transition.

DHA also will be a key part of the DoD's effort to build a new electronic health record and ensure interoperability with the Veterans Affairs Department.

Bowen said a number of initiatives will be coming online soon to automate records that were sent to VA in a paper form previously.

"One of the efforts includes an effort around standardizing our clinical terminology so that we basically translate certain clinical terms from the terms we use to the terms VA uses and vice versa," he said. "We are looking at seven areas initially where we have certain standards and we can take the VA terms and turn them into a standard term and turn that standard term back into a DoD term for our folks to look at and vice versa for the VA folks to look at."

Bowen said these seven areas are just the start and the effort to standardize data will continue over the next few years.

RFP for EHR coming

This standard setting initiative is part of the broader effort DHA also is a part of with the DoD-VA Interagency Program Office.

Bowen said the IPO also will focus on data sharing and interoperability and the newest area, the Defense Health Management System Modernization, which is the acquisition strategy to acquire a new electronic health records system.

DoD released a request for information in September and is planning a final solicitation in the coming weeks.

Bowen said DHA will become more involved after DoD awards the contract for a new health records system.

"We will work with them to begin configuring the newly acquired system. It will take some time to do that," he said. "We will develop an organization that will basically take over and sort of deploy that throughout out system and move into a sustainment mode for the years to come."


Live Online Chat: Dave Bowen, the director of health care IT and CIO of the Defense Health Agency, will join Federal News Radio's Jason Miller for a live online chat Monday, Jan. 13, at 1 p.m. Registration for this free event is required. Pre-registration is now open and will continue through Friday, Jan. 10, at 4 p.m. REGISTER NOW FOR FREE.

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