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).
DoD Seeks Significant EHR Overhaul
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.
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.”
Undersecretary Brothers responded by providing an overview of S&T’s current R&D priorities, which are guided by the quadrennial homeland security review and the direction of DHS Secretary Johnson:
DoD Struggles with R&D
Department of Defense officials have been increasingly concerned with the deteriorating state of the US military’s technological superiority as a result of low cost disruptive technologies.
The proliferation of low cost, disruptive technologies coincides with a dramatic decrease in publicly funded defense Research Development Test and Evaluation (RDT&E) spending from the DoD: the FY 2014 budget allocated just $63 billion to RDT&E, compared to the nearly $80 billion allocated in FY 2009. Additionally, US private sector RDT&E defense spending has fallen dramatically in terms of percentage, as well, with the largest US Defense contractors reinvesting only 1-2% of sales back into R&D. In response, senior DoD leadership has developed new initiatives to foster innovation and maximize reduced budgets through new technological offset strategies, cost sharing between close US allies, and acquisition reforms.
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