Business models for cost effective use of health information technologies: lessons learned in the CHCS II project

The Department of Defense (DoD) has embarked on an initiative to create an electronic medical record for all of its eligible beneficiaries. The Clinical Information Technology Program Office (CITPO) is the joint-service program office established to centrally manage this multi-year project. The Composite Health Care System II (CHCS II) is the name of the system under development. Given the historical failure rate of large-scale government information system projects, CITPO has employed an incremental acquisition approach and striven to use industry best practices to the greatest degree possible within the constraints of federal acquisition law. Based on lessons learned during the concept exploration phase of this project, CITPO, in partnership with Integic Corporation, the prime integration contractor, has reengineered its software acquisition process to include industry best practices. The result of this reengineering process has resulted in a reduction of the total projected life cycle costs for CHCS II from the original estimate of $7.6 billion over a 14-year period to between $3.9 and $4.3 billion.