DoD Seeks Significant EHR Overhaul

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The Department of Defense (DoD) is in the midst of selecting a vendor to overhaul its electronic health record (EHR) systems, which facilitate the transfer of information pertaining to patient’s medical history, conditions, prescriptions, and other data across multiple healthcare providers over time. The Healthcare Management Systems Modernization (DHMSM) program is projected to cost $11 billion through the year 2023. DHMSM will replace the DoD’s existing EHR system, the Armed Forces Health Longitudinal Technology Application (AHLTA), as well as elements of the Theater Medical Information Program-Joint (TIMP-J) and the inpatient Composite Health Care System. When DHMSM launches in 2017, it will become the largest EHR system in the United States, with more than 9.6 million patients associated with over 400 hospitals (Brewin, 2014).

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Big Data Developments within NIH

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Despite the relatively flat budget in recent years, the National Institutes of Health (NIH) is undergoing changes which will better equip the agency to collect and analyze large biomedical data sets. The cancelation of the NIH’s National Children’s Study (NCS) and the continued investment in the Big Data to Knowledge (BD2K) initiative is indicative of the agency’s efforts to adapt towards recent technological advancements in big data over older more conventional means of collecting biomedical data. 

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Budget Brief: FY 2015 NDAA

The Carl Levin and Howard P. McKeon National Defense Authorization Act (NDAA) for fiscal year (FY) 2015 passed the Senate Friday night by a bipartisan vote of 89-11, after the House passed the measure 300-119. The bill includes $495.9 billion for the Department of Defense’s (DoD) base budget, $63.7 billion overseas contingency operations (OCO) budget, and $17.9 billion for the Department of Energy related to maintaining the nation’s nuclear arsenal (Alexander, 2014). The FY 2015 NDAA also institutes a host of provisions related to curbing military benefits, creates a new DoD leadership position – the Under Secretary of Defense for Business Management and Information (USDBMI), and provides the Navy with billions in extra procurement funding.  

The 2015 NDAA enacts measures to curtail rising DoD personnel costs, such as increasing co-pays related to prescription drugs by $3, decreasing pay raises to 1% - below the current rate of inflation, and prohibiting further wage raises for flag officers. Departing Chairman of the Senate Armed Services Committee Carl Levin expressed his concern that the spending caps imposed by sequestration, in conjunction with rising of personnel costs will erode military readiness.

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Developments in DHS-S&T

The House Subcommittee on Cybersecurity, Infrastructure Protection, and Security Technologies & the Subcommittee on Research and Technology recently held a joint hearing on the potential re-authorization of the Department of Homeland Security’s (DHS) Science and Technology (S&T) directorate. S&T’s objective is to develop new technologies for agencies under DHS such as the Transportation Security Administration, Coast Guard, Federal Emergency Management Agency, etc. to better protect the homeland from a wide variety of threats. Representatives from both committees were concerned on the level of redundant research programs within S&T’s $1.2 billion budget across DHS; Chairman Lamar Smith highlighted a government accountability office report which described S&T’s R&D management approach as “fragmented and overlapping.” 

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Federal Spending on Ebola Set to Exceed $1 Billion 

The Obama Administration has requested $1 billion in Department of Defense (DoD) reappropriations to augment efforts to contain the outbreak of Ebola in West Africa. 

As of late October, the House Appropriations, House Armed Services, and Senate Armed Services committees have approved $750 million dollars in DoD reappropriations, which will come from the overseas contingency operations (OCO) budget, though the Senate Appropriations Committee (SAC) has yet to approve this request. Chairwoman Barbara Mikulski (D-Md.) announced the SAC will hold a hearing on Ebola reappropriations on November 6th, shortly after the midterm elections. 

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