Fiscal Year (FY) 2016 Budget Estimates Defense Health Program Procurement Budget Item Justification



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APPROPRIATION / BUDGET ACTIVITY : P-1 ITEM NOMENCLATURE: Replacement/Modernization 97*0130 FY 2014 FY 2015 FY 2016 FY 2016 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 641.577 283.030 330.504 0.000 330.504 395.504 408.424 451.163 448.997 Dental Equipment 0.541 0.299 0.308 0.000 0.308 0.323 0.335 0.348 0.362 Food Service, Preventive Med, Pharmacy Equipment 12.861 1.466 1.828 0.000 1.828 2.971 3.220 3.450 3.543 Medical Information System Equipment 186.476 141.937 149.897 0.000 149.897 179.483 170.306 193.193 182.412 Medical Patient Care Administrative Equip 11.156 3.144 4.470 0.000 4.470 6.170 6.485 6.763 6.848 Medical/Surgical Equipment 54.261 13.824 18.238 0.000 18.238 26.274 28.027 29.702 30.630 Other Equipment 171.387 4.805 7.829 0.000 7.829 8.654 13.143 14.834 15.060 Pathology/Lab Equipment 19.990 11.614 11.685 0.000 11.685 17.749 19.268 20.272 20.960 Radiographic Equipment 184.905 105.941 136.249 0.000 136.249 153.880 167.640 182.601 189.182 DHP-1

The most significant medical equipment investments will be in the radiographic, surgical, and information systems functional areas. The driving factors are rapid technological advancements in these areas and the need for DoD s health care delivery system to maintain the standards of care set by the civilian health care sector. Procurement investments for information systems will cover software license acquisitions, infrastructure, hardware replacement such as End User Devices, Local Area Network (LAN) upgrades and servers supporting Military Health System (MHS) Information Management/Information Technology (IM/IT) which is composed of the MHS Health Information Technology Program (Tri-Service component, previously known as centrally-managed IM/IT), three Military Departments (MilDep) medical IM/IT components, Defense Health Agency (DHA) IM/IT, and the National Capital Region Medical Directorate (NCRMD) IM/IT. Funding will also support deployment of the Wounded, Ill, Injured (WII) Health Artifact and Image Management Solution (HAIMS). Financing an adequate equipment acquisition budget is critical in retaining the Department s medical workload in-house and controlling purchased healthcare costs in the private sector. The items supported by this budget are the result of an extensive investment equipment justification process and are necessary to provide properly trained medical department personnel and high quality, cost effective health care services for the eligible beneficiary population. DHP-2

APPROPRIATION / BUDGET ACTIVITY : 97*0130 P-1 ITEM NOMENCLATURE: New Facility Outfitting FY 2014 FY 2015 FY 2016 FY 2016 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 64.187 13.057 33.392 0.000 33.392 20.347 9.530 26.538 11.554 Dental Equipment 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Food Service, Preventive Med, Pharmacy Equipment 9.355 0.193 1.181 0.000 1.181 0.258 0.089 0.344 0.152 Medical Information System Equipment 3.708 3.190 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Medical Patient Care Administrative Equip 0.000 0.000 1.474 0.000 1.474 0.000 0.000 0.000 0.000 Medical/Surgical Equipment 13.472 0.993 1.819 0.000 1.819 1.285 0.442 1.717 0.758 Other Equipment 14.474 6.167 14.915 0.000 14.915 14.305 7.457 18.511 8.020 Pathology/Lab Equipment 1.868 0.236 1.978 0.000 1.978 0.316 0.109 0.420 0.186 Radiographic Equipment 21.310 2.278 12.025 0.000 12.025 4.183 1.433 5.546 2.438 DHP-3

The new facility outfitting program element of the DHP Procurement Budget funds the acquisition and installation of commercially available equipment to furnish new and expanded facilities being completed under military construction projects in support of dental services, health care delivery, health care training, and other health care activities. The items range from dental, surgical, radiographic, and pathologic equipment to medical administrative support equipment. The new facility outfitting program provides critical support to the Military Health System s military medical construction program. DHP-4

APPROPRIATION / BUDGET ACTIVITY : 97*0130 P-1 ITEM NOMENCLATURE: Theater Medical Information Program - Joint (TMIP-J) FY 2014 FY 2015 FY 2015 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 0.000 3.145 1.494 0.000 1.494 2.413 2.689 2.850 2.907 TMIP-J 0.000 3.145 1.494 0.000 1.494 2.413 2.689 2.850 2.907 The Theater Medical Information Program - Joint (TMIP-J) integrates components of the Military Health System sustaining base systems and the Services medical information systems to ensure timely interoperable medical support for mobilization, deployment and sustainment of all Theater and deployed forces in support of any mission. Funding will be used for implementation and training through FY15. Starting in FY16, Procurement funding transitions to support Operational Medicine Support implementation and training activities (FY16 = $1.494M, FY17 = $2.413M, FY18 = $2.689M, FY19 = $2.850M, and FY20 = $2.907M). DHP-5

APPROPRIATION / BUDGET ACTIVITY : 97*0130 P-1 ITEM NOMENCLATURE: Integrated Electronic Health Record FY 2014 FY 2015 FY 2015 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 0.000 9.181 7.897 0.000 7.897 1.043 0.075 0.076 0.079 EHR 0.000 9.181 7.897 0.000 7.897 1.043 0.075 0.076 0.079 The former joint DoD and Department of Veterans Affairs (VA) Electronic Health Record (EHR) program has been restructured within the DoD to pursue two separate but related healthcare information technology efforts, the DoD Healthcare Management System Modernization (DHMSM) program and the DoD EHR/Defense Medical Information Exchange (DMIX) program. In the Under Secretary of Defense for Acquisition, Technology and Logistics (USD (AT&L)) Acquisition Decision Memoranda (ADM), dated June 21, 2013 and January 2, 2014, the former joint DoD and VA Integrated Electronic Health Record (iehr) program was restructured to pursue two separate but related healthcare information technology efforts, the DoD Healthcare Management System Modernization (DHMSM) program and a newly defined iehr, Defense Medical Information Exchange (DMIX), focused on providing seamless integrated sharing of electronic health data between the DoD and VA. The remaining iehr Increment 1 (iehr Inc 1) was significantly descoped to only the Medical Single Sign-on/Context Management (MSSO/CM) implemented at James A. Lovell Federal Health Care Center (JAL FHCC). DHP-6

APPROPRIATION / BUDGET ACTIVITY : 97*0130 P-1 ITEM NOMENCLATURE: Information Technology Development and Sustainment - DoD Healthcare Management System Modernization FY 2014 FY 2015 FY 2015 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 0.000 0.000 0.000 0.000 0.000 181.458 663.956 684.084 699.014 DHMSM 0.000 0.000 0.000 0.000 0.000 181.458 663.956 684.084 699.014 Information Technology Deployment and Sustainment - DoD Healthcare Management System Modernization (DHMSM) will acquire and support deployment, implementation, and sustainment of an electronic health record (EHR) system that replaces the DoD legacy MHS inpatient and outpatient EHR systems. Overarching goal of the program is to enable healthcare teams to deliver high-quality, safe care and preventive services to patients through the use of easily accessible standards-based computerized patient records resulting in: improved accuracy of diagnoses and impact on health outcomes; increased patient participation in the healthcare process; improved patient-centered care coordination; and increased practice efficiencies in all settings, including operational environments. DHP-7

APPROPRIATION / BUDGET ACTIVITY : 97*0130 P-1 ITEM NOMENCLATURE: DoD Medical Information Exchange and Interoprability FY 2014 FY 2015 FY 2015 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 Cost ($ M) 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 DHMSM 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 DoD Medical Information Exchange and Interoprability (DMIX) program will acquire the capabilities necessary to securely and reliably exchange standardized, normalized, and correlated health data with all partners through standard data/information exchange mechanisms. This allows users in different places and different organizations to access, use, and supplement health data (technical interoperability) that has a shared meaning so users (assisted by computers) are able to make care decisions (Semantic Interoperability Level 4). DMIX manages the data exchange capability from legacy data stores in order to prepare for the transition to the modernized Electronic Health Record platform being acquired by DoD Healthcare Management System Modernization (DHMSM). DMIX consists of a family of capability initiatives supporting the seamless exchange of standardized health data among DoD, VA, other Federal agencies, and private providers as well as benefits administrators. The DMIX program provides the capability for health care providers to access and view complete and accurate patient health records from a variety of data sources thereby allowing healthcare providers to make faster and higher quality care decisions. DMIX was established in accordance with the joint memo from Under Secretary of Defense (Comptroller) and USD(AT&L) titled "Joint Memorandum on Major Defense Acquisition Program and Major Automated Information System Program Resource Transparency in Department of Defense Budget Systems" dated June 27, 2013. DHP-8