DoD Ditches Open Source Medical Records System In $4.3B Contract

dmr001 writes: The US Department of Defense opted not to use the Department of Veterans Affairs' open source VistA electronic health record system in its project to overhaul its legacy systems, instead opting for a consortium of Cerner, Leidos and Accenture. The initial $4.3 billion implementation is expected to be the first part of a $9 billion dollar project. The Under Secretary for Acquisition stated they wanted a system with minimum modifications and interoperability with private sector systems, though much of what passes for inter-vendor operability in the marketplace is more aspirational than operable. The DoD aims to start implementation at 8 sites in the Pacific Northwest by the end of 2016, noting that "legacy systems are eating us alive in terms of support and maintenance," consuming 95% of the Military Health Systems IT budget.

Comments

A consortium of Cerner, Leidos and Accenture

[Anonymous Coward]

Jesus Christ what a waste of money and to the worst possible people.

Re:A consortium of Cerner, Leidos and Accenture

[Anonymous Coward]

Their only noncommercial option was the VA's VistA, requiring constant redevelopment to meet federal HITECH and ONC mandates and built entirely around a 1960s-era "key-value" database language called MUMPS. If you're a migraine enthusiast, enjoy night terrors, or otherwise are in the market for a drinking problem I recommend learning MUMPS.

Here's a high-level summary of MUMPS:
There is no database. Everything is stored in a multidimensional array. There are no ints or floats. Everything is stored and retrieved as a string. There are no reserved names because the entire language is context-based. There are no tables, tablespaces, or schemas. Everything in the global array is persistent and is saved directly to a disk. All program code is stored and executed within the global array alongside production data. Scared yet?

P.S. MUMPS is also the underlying database technology of the other DoD front-runner, Epic Systems, widely regarded in the industry to be the most expensive EHR software ever developed. So all things considered, I think the DoD could have done worse.

Re:A consortium of Cerner, Leidos and Accenture

[arglebargle_xiv]

A large-scale medical records system, a multibillion-dollar IT project, and companies like Accenture doing it, it's like combining herpes, syphillis, and gonorrhea and hoping you'll get a cure for cancer. Any of of those in isolation is pretty much pre-ordained to fail, and they're combing them all into one massive clusterfsck... why don't they just declare failure in advance and save the years of effort (and money).

Trading one for the other

[grilled-cheese]

It's interesting how they see integrating legacy systems any differently integrating just as many differently implemented commercial record systems. The data integrators will make the same money either way. By abandoning the open-source solution, you're just losing the possibility others might benefit from the work. Likewise, I'm curious how much those 3 vendors have lobbied in Washington DC.

Re:Trading one for the other

[Anonymous Coward]

The open source solution was not a good one in this case. You can have religious wars all you want about which language is best, but when striving for worst, MUMPS is a real contender. Please don't copy the database structure of VISTA. It's utterly useless for data integrity -- imagine a database where every field is a string. There are no numeric fields...and what happens? Oh.

The biggest problem is that the DoD lacks the organizational and technical skills at higher levels to use anything other than a defacto standard. They need something akin to RFC's, but that is not the military way.

The $9B price tag is actually reasonable for a good implementation and rollout. We know history too well: no one will see anything from the project for 10 years, and it will be rolled out on top of a lackluster Oracle database and dozens of middleware pieces that will ensure the system remains more expensive than current operation costs forever. And it will probably be less functional that what it replaces.

It's a shame that such big consumer lacks the power to make a difference in the market by developing and promoting good standards.

Yes, I'm bitching. I've been in the system long enough to lose hope.

Re:Trading one for the other

[phantomfive]

Regardless of whether they are starting with open source software, or closed source software........if I ever paid $4.3 billion for some software, I guarantee I would be getting the source for it. If the government pays that much for a system, one of the requirements should be that it ends up open source.

$4.3 billion == guaranteed failure.

[serviscope_minor]

As far as I can tell, any IT project costing a billion or more is 100% guaranteed to fail.

Also, it sounds like they decided to source IT from Lufier, Mephistopheles and Satan, which incidentally also guarantees it to fail.

Re:$4.3 billion == guaranteed failure.

[wonkavader]

Tom DeMarco talks about the air traffic control software project in one of his books. The description of the hopeless situation in that case supports your idea.

I think when you have a lot of people's butts on the line and so failure is not an option but stagnation IS, what we would perceive as failure is almost certainly coming. You can retire without any fallout so long as you make sure nothing happens for 15 years. It's easy to do: Just make the specs vague, self-contradictory, and long. Very, very, long.

The project won't fail, but it won't succeed either. And you're safe, which is all that matters.

They would do much better to set up a few small teams and have them compete to build something with enough in common so one can be replaced by the other. And starting with the open source base would make sense there.

Re:$4.3 billion == guaranteed failure.

[dinfinity]

As far as I can tell, any IT project costing a billion or more is 100% guaranteed to fail.

No kidding.

If you pay everybody $200 000 per year, that equates to 21 500 man-years (!) of work. I don't know what kind of problems in record keeping they're going to solve, but for that kind of money it'd better involve employees doing that in gold plated jets flown by an artificially engineered unicorn that continually snorts prime-grade cocaine.

Accenture?

[Anonymous Coward]

Project already failed.

$4.3 billion

[lkcl]

wow fuck. imagine how much advancement in software libre could be had for $4.3 billion if the contract had been awared. hell, even 1% of that would make a big fucking difference. someone - such as the gnumed developers to take even one random example - could, with help, have developed a medical records system for ohhh i dunno... the U.S. Dept of Defense, with that kind of money. just to take a random example, y'ken.

Part of the problem

[satsuke]

That is part of the problem .. trying to design a drop in replacement that replicates the current functionality and interoperability with other systems.

With government especially, you have lists of exceptions and custom one-off code to get something working, that it becomes impracticable to replace it without an equal or additional number of exceptions.

It's the kind of system that benefits from a "flush it all away" mentality of defining new standards and sticking to them.

gnu project? really?

[Anonymous Coward]

And who, in the gnu community, is going to take on the responsibility for all the enterprise scale stuff that needs to be done. I can see lots of folks wanting to scratch their particular itch by coding up some piece, but who's going to do the architecture design, ride herd on the developers, etc.; make sure that the documentation gets done and is usable and readable (because, ya know, all those packages out on github and sourceforge are ever so well documented)..

I mean responsibility as in "be willing to stand up in front of Congress and explain your progress or lack thereof". I don't see a Linus or Theo or Eric or, gods forbid, Richard, filling that role.

Re:follow the money

[greenwow]

Exactly. This is just more disgusting Republican corporate welfare.