Industry Archives

I'm not talking about the disease -- although some folks treat it as such -- but the software that is the heart of the Veterans Health Information Systems and Technology Architecture, the electronic health record system at the Veterans Affairs Department.

The big obstacle for MUMPS is the perception that no one except VA uses it, a simplistic view reinforced by Sen. Richard Burr, R-N.C., during a hearing on the future of VA information technology systems on Tuesday.

At about the same time Burr was bashing MUMPS, the Coast Guard awarded a $14 million contract to Epic Systems Corp. for an electronic health record system based on MUMPS. That should be no surprise because Judy Faulkner, Epic's chief executive officer, founded the company in 1979 after working on MUMPS for VA.

Faulkner has grown Epic into a giant in the heath care IT field, including a megabillion dollar contract with Kaiser Permanente, which has 8.6 million patients and 15,000 doctors. The company competes with Genera Electric Healthcare, which also based its software on MUMPS. The last I checked, GE was no mom and pop oufit.

So, why, of why, do VA and its chief information officer, Roger Baker, want to move off a MUMPS-based VistA, and why is the Defense Department considering Epic when they can tap into the stable and free system Faulkner based her company on?

Veterans Affairs Secretary Eric Shinseki personally called the chairman and chief IBM, Samuel Palmisano, this summer to express his dissatisfaction with the company's progress on development of a computer system to process veterans' claims for ailments associated with Agent Orange, VA Chief Information Officer Roger Baker told the Senate VA Committee on Wednesday.

Baker alluded to a post I wrote in September on Shinseki's pique with IBM.

Contractors often run late on government information technology contracts, and IBM did not "understand it was not business as usual" when it came to the small-($9.1 million)-but-important-Agent-Orange project, Baker said in response to a question from the committee's ranking member, Sen. Richard Burr, R-N.C.

IBM got the message it needed to meet its 90-day delivery schedule for the system after Shinseki called Palmisano, he told Burr. "Its not every day a Cabinet secretary calls a CEO," Baker said.

He also said he expects IBM to meet the delivery schedule, but may need a backup if IBM misses it. VA issued a proposal for a second contractor in September, although the department has not issued an award.

VA expects to be hit with 240,000 claims from Vietnam veterans exposed to the Agent Orange defoliant and Burr said the VA definitely needs the Agent Orange system as it faces "an implosion of the claims process".

Now, if only IBM and VA would answer my multiple, more-than-month-old queries on what problems they have encountered with the Agent Orange claims system, what it's supposed to do, and when it will go into operation.

In his testimony given before the House Armed Services Committee on Thursday, Gen. Keith B. Alexander, commander of the U.S. Cyber Command, cited Apple's iPad, which costs $499 and up, as an example of the challenges the nation faces as it attempts to operate in a global and amorphous cyber space.

Alexander, who bought an iPad shortly after Apple put it on the market in April, told the hearing the device illustrates advances in technology during the past two decades. "Its capability surpasses
that of even NASA computers of 20 years ago," he said.

The iPad packs millions of lines of code into a consumer product, Alexander said, which may help understand "the complexity of our new world and the ways in which our economy and society have shifted to an information culture, where wealth is less and less rooted in the physical ability to manipulate objects than it is in the knowledge of how those objects work together."

The information economy has a lot of bad actors, who can also afford technology, he said. Alexander views the best cyber defense is one based on culture and procedures, rather than technology.

"Purely technological advantages are likely to be fewer and less lasting in our networked world," he said. "Our advantage has to lie in how we put these tools together in systems, especially systems of people, protocols and machines that can operate reliably together at high speeds to identify vulnerabilities, share information, assess risks, devise countermeasures and apply new solutions," without providing details.

What's next? An iPad cyber defense app?

In July, the Veterans Affairs Department awarded IBM a $9.1 million contract to develop within three months a system to process claims for Vietnam veterans suffering from diseases stemming from exposure to the Agent Orange defoliant sprayed in that country by the Air Force. (The service's units had the motto: "Only you can prevent forests.")

VA presumes all 2.6 million veterans who served in Vietnam had exposure to Agent Orange. If veterans have one of 15 diseases -- including hairy cell leukemia, Parkinson's and ischemic heart disease, which were added
to the list on Aug. 31 -- they don't have to prove they were in an area where the defoliant was sprayed and their diseases resulted from military service.

The new approach to Agent Orange will add 240,000 claims to its case load, which is why it tapped IBM to build a separate system to process machine readable claims that veterans submit electronically.

VA Secretary Eric Shinseki hailed the approach as "a new way of doing business and a major step forward in how we process the presumptive claims we expect to receive over the next two years."

But after spending a month chasing rumors and tips, I'm told IBM quickly ran into problems trying to build, by the end of this year, a system that would process 30,000 claims.

I have confirmed with multiple sources that an angry Shinseki last month personally called top IBM management to express his dissatisfaction with the lack of progress on the system. I'm also told VA officials followed up Shinseki's call with a formal letter to IBM telling it to get its act together.

This probably explains why early this month VA issued a notice that it would like to find a second contractor to develop an Agent Orange claims processing system, with the ability to start within 15 days of award.

IBM officials did not respond to multiple calls placed during the past month about the status of the Agent Orange claims processing system. VA spokeswoman Katie Roberts declined to comment on whether or not a piqued Shinseki called IBM.

The Senate Appropriations Committee added $13.4 billion to the fiscal 2010 Supplemental Appropriations Bill this to foot the bill for the Agent Orange claims.

But Sen. Jim Webb, D-Va., a Marine Vietnam veteran, doubts everyone who served in Vietnam was exposed to Agent Orange, and he wants Shinseki to explain his case at a hearing of the Senate VA committee scheduled for 9:30 a.m. EDT on Thursday.

The Congressional Review Act gives Congress 60 days to review regulations before they go into effect, which means Congress could derail the new Agent Orange rules between now and the end of October.

(Full disclosure: I served in the Marine Corps in Vietnam in 1965 and 1966, and have been in the VA Agent Orange Registry since the mid-1970s.)

As anyone who has served in combat knows, if a buddy is wounded, the first two things you need to do are make sure he can breathe and his bleeding is stopped.

For the past several years, troops serving in Afghanistan and Iraq have used an advanced Combat-Application-Tourniquet (C-A-T) developed by Composite Resources in Rock Hill, S.C. The tourniquet features a nylon strap and a plastic rod to tighten the strap to stop bleeding.

The regulation C-A-T costs about $28. But about two years ago the Army detected cheap knock offs made by a Hong Kong company that had entered the military's supply chain in Afghanistan and Iraq. The imitation sold for about $8.50.

They're accurate looking fakes, right down to the label and national stock number.

But as Col. John Kragh, a doctor at the U.S. Army Institute of Surgical Research at Fort Sam Houston, pointed out in June, the rod on the fake tourniquet "is bendable to a point where it cannot work right. It's like bending Gumby's arm."

He said the fake tourniquet could be fatal because it cannot stop bleeding. Kragh added a decentralized ordering system probably accounts for the presence of the fake tourniquets in the field, with low-level supply personnel ordering the knock offs over the Internet based on price.

The Defense Department issued a warning about the knock-offs in April, Kragh said, and the Food and Drug Administration this month put out a safety alert about the tourniquets, which are also used by civilian first responders.

The lesson here is a good deal isn't always that; it can even be deadly.

I reported on Aug. 20 that the folks over at the National Geospatial Intelligence Agency determined only Google had the smarts to handle visualization of the planet.

NGA said in a FedBizOps announcement last week that it planned to award Google a sole-source contract for Web-based access to geospatial visualization services because the company was the only outfit on Earth that could meet the viewing requirements.

Not so fast, said Microsoft, which told me that the MS Bing Map Server could do the job, too.

Now it appears NGA has re-thought, at least, the wording of the Google sole-source contract.

Karen Finn, the amazingly responsive NGA public affairs chief, told me in an e-mail that the agency is going to post a revised Earth visualization notice on Wednesday that will be more "technically specific on the requirements for support and license. NGA appreciates all interest and believes the revised synopsis will explain NGA's requirement with more specificity. Interested parties may still respond to the revised synopsis."

Watch this space on Wednesday for another planetary update.

Here's a loopy procurement that Defense Secretary Robert Gates should cancel immediately if he's serious about saving money: The General Officer Transition Course hatched last week by the Army Contracting Center of Excellence.

ACE wants to spend some taxpayer bucks to teach the about-to-retire generals such hard to learn stuff as proper civilian senior executive attire.

I'll make that easy (at no charge to ACE and the retiring generals): Take thyself to Brooks Brothers and ask a sale person to outfit you with a suit, matching shirt and tie, (or a fine dress and blouse for the women generals) and you will only need a small second mortgage to buy four complete rigs. Brooks even does underwear, which I find much more comfortable than military skivvies.

ACE also wants a contractor to teach generals how to write resumes, search for a job (including, I kid you not, how to look at job ads) and how to conduct a job interview. (My advice: Leave the Hooahs at home.)

How come there's no PFC Transition Course?

I reported on Monday the Military Health System decided to consider commercial software for its loathed AHLTA electronic health record system. The folks over at MHS told me the planning process started in December 2009, with establishment of an EHR Way Ahead Planning Office this February.

For those into wiring diagrams and org charts, the EHR Way Ahead Planning Office (EWAPO, right?) resides within the MHS Joint Medical Information Systems Program Executive Office under the Office of the Chief Information Officer.

Mary Ann Rockey, acting MHS CIO (she's acting because Chuck Campbell, the CIO, has been dispatched to the "in limbo" ASD/NII, an organization slated for whatever lies beyond limbo) told me in an e-mail EWAPO was stood up "to look into the options available for the future of the military's electronic health record."

The Navy wants to beef up its networks at Camp Lemonnier in Djibouti, headquarters for the Combined Joint Task Force -- Horn of Africa. So the service invited interested vendors to attend a two-day briefing there next month.

Based on the medical requirements to attend the event, I think only vendors truly desperate will attend.

To make the gabfest, vendors will need to have been administered a yellow fever shot, malaria pills, a TB test and have undergone a full examination by their primary care physician, the Navy said. It added a warning: Camp Lemonnier has limited medical facilities.

The camp -- and I empathize with the troops pulling a year tour there -- is an old French Foreign Legion post, located between the runways of the Djibouti airport and a French ammo storage facility.

The weather also may serve as a disincentive for attracting large crowds of widgeteers. The temperature on Tuesday was a crispy 104 degrees. I can't begin to imagine the temperature in July.

I don't think the vendor who whined about driving from Washington to Eatontown, N.J., for a Veterans Affairs Department industry day has any plans to make the Djibouti gig.

I'm just guessing.

D'Val Westphal, the "Road Warrior" correspondent for my local paper, the Albuquerque Journal, had a insightful column on Monday on why we should never, ever fully trust Google maps to get directions.

The Albuquerque International Sunport -- the grandiloquent name for the local airport that has no international flights -- adjoins and shares runways with Kirtland Air Fore Base.

If you use Google Maps to get directions from Santa Fe to the airport, you'll be taken not to the airport terminal but to the front gate of Kirtland, Westphal pointed out in her article. (Subscription required.)

A bemused security guard at Kirtland kept wondering why panicked tourists rushing to make a flight kept ending up at his post. The guard soon discovered they all had been misdirected by Google, Westphal said.

The unnamed guard then went online to fix the Google Map problem. That worked for about a week until Google reverted to its old ways and, once again, guided folks to Kirtland.

Westphal then called Google, to little avail, because, well, as you know, the telephone and Alexander Graham Bell are so 19th century.

Maybe the column will finally spur Google to stop funneling innocents the wrong way to the Sunport. Kudos to Westphal and the security guard at Kirtland for taking the human approach to solve a digital problem.