Many health system chief information officers say they weren't expecting the Cerner/Leidos team to win the coveted contract to overhaul the Department of Defense's electronic health record system.

The Cerner team beat the favored Epic/IBM/Impact Advisors team, as well as one that included Allscripts, Computer Sciences Corp. and Hewlett-Packard.

"Initially I was surprised," admits Bruce Kelly, chief information officer of ProMedica Monroe Regional Hospital in Monroe, Mich. "I really thought it was going to Epic because they seem to be winning everything."

David Chou, CIO at the University of Mississippi Medical Center in Jackson, Miss., had also predicted an Epic win. "The decision came as a surprise, but I don’t think it is a bad choice. Overall, they wouldn’t have gone wrong with either choice."

The DoD contract, which is valued at $4.3 billion over five years, includes the digitizing of health records for over 9.5 million beneficiaries across about 1,000 hospitals and clinics. The project also requires that the Cerner electronic health record supports the electronic sharing of patient records with other EHRs in the private sector.

Chou points to Leidos' experience within the government sector as one factor that gave an edge to the Cerner partnership. "Leidos knows how to navigate within the sector and has done lots of work from a security aspect," said Chou. "They’ve built solid relationships working in government for years.

David Tucker, vice president of business development for healthcare IT consulting firm ESD, agrees that the federal successes of Leidos and Accenture contributed to the Cerner win.  

"I was surprised at the outcome but I shouldn’t have been," said Tucker. "Cerner will do a good job and Leidos is a good company. The government relationships they have built led to the win."

Art Glasgow, the former chief product officer at Optum and former CIO of Duke University Health System, believes that the selection was based more on implementation experience than the actual EHR software.

"We look at this from the myopic view of healthcare IT – but the government looks at this as a large-scale outsourcing contract," said Glasgow. "From the standpoint of what will make the implementation successful it has less to do with the EHR platform and more to do with the implementation partner."

In addition to partner strength, Kelly believes Cerner likely had the upper hand in terms of sales skills. "Cerner is a selling machine and they do a very good job of selling their product," notes Kelly. "Epic thinks they are the de facto winner all the time and they don’t know how to sell because they haven’t needed to sell.

"But that’s not how the government works. They have a whole process they go through and Epic isn’t geared to deal with that."

Chou believes the selection of Cerner should be good for the market. "Epic dominates the US market and this may prevent them from having a monopoly," said Chou. "It’s good to have competition between two big rivals and great organizations."

One person expressing less enthusiasm over the DoD’s selection is athenahealth CEO Jonathan Bush. "The opportunity that came with the DoD contract was to build a national health information network that could ensure patients’ health information could follow them no matter where they went," said Bush.

"Given the DoD’s decision, I’m not optimistic we will see this. By partnering with the very same legacy HIT system vendors who are largely responsible for the current state of disconnected healthcare, the DoD is making a long slog toward the type of interoperable infrastructure the ONC mapped out in its 10-year plan."

Glasgow, on the other hand, believes the project should advance interoperability efforts, especially at a local level. "The DoD is pretty widespread and it will force if not innovation, at least execution against existing interoperability standards.

"The VA is tightly intertwined at the local level with community and academic hospitals," said Glasgow, who is currently working as an independent industry consultant. "This will make it the largest interoperability demo that there is."

Tucker is optimistic that the Cerner team will achieve its goals. "It sounds like Cerner and its partners are in good shape to do this," said Tucker. "I have no doubt that they will be successful. It will be interesting."