effect on the FY18 budget,” Wells points out. “[The new per-
son] will have to find ways within the system to understand
and leverage the maximum percent possible—and then be
prepared, for whenever the next budget window comes up, to
be able to take these actions to eliminate wasteful programs.”
As part of this effort, the CIO must publish a top priorities
list within 30 to 60 days of his or her arrival, the report notes.
However, it also emphasizes that all parties must understand
that this will be “a living list”—it will be modified.
A key to success will be to avoid either of a pair of familiar
pitfalls, Wells states. One is the failure of the DHA’s pending
rollout of its electronic health record (EHR) system. This
rollout needs to occur smoothly for the agency to serve its
customers well. One of the report’s five recommendations
states, “No matter what happens, DHA cannot be seen as the
cause for delays in the EHR rollout. Ensure this project gets
the attention it needs for success.”
The other pitfall to avoid is a cybersecurity data breach.
This also is one of the report’s top recommendations. A
major failure in this realm would have devastating effects on
the DHA’s customers and reduce the chances of the agency
regaining credibility, Wells says. “Ensure that the chief infor-
mation security officer (CISO) is empowered, and adequately
fund efforts to protect data. This is a two-part mission to pre-
vent a breach and to ensure resiliency and continuous opera-
tions,” the report declares.
“Those are the kind of alligators in the swamp that will
snap you up while you understand the baseline environment,
identify the budget mechanisms and establish guidelines for
industry interaction,” Wells says, citing the other key recommendations in the report.
The report notes that the DHA’s move to a new EHR system will affect virtually every aspect of the agency’s information technology operation. It should result in millions of
dollars in cost savings, mostly through streamlining operations and eliminating redundancies. Yet the EHR system will
be the biggest long-term line item in the budget, consuming
an estimated 60 percent of information technology funding
even after it is deployed.
One of the biggest EHR challenges lies in legacy systems,
which must be replaced to free up long-term funds. Wells
offers the rollout of the Navy Marine Corps Intranet (NMCI)
as an example that can provide lessons for the EHR conversion. With the NMCI, initial responses were “completely
overly optimistic,” he relates, because these estimates did not
fully account for the number of systems that would have to be
replaced at Navy and Marine facilities. Wells says he is certain
that comparable issues will emerge with the EHR rollout,
although what they are is not clear yet.
Even if the goal is to eliminate all legacy applications, this
may not be possible, he continues. But some actions may prevent these apps from impeding the EHR rollout. “The plan …
going in ought to be to mitigate the consequences rather than
assume them away,” Wells suggests.
Another top recommendation in the report is to identify
budget mechanisms and core funding issues. This touches
on the diversity of the DHA’s customers and accompany-
ing redundant systems. The report recommends that, where
multiple systems exist for the same function, the CIO should
“choose a winner and move forward.”
The report also suggests establishing clear guidelines for
industry interaction, which will require creating clear mecha-
nisms and goals. The CIO will need to issue a document that
outlines key problems and focus areas. Another move would
be to establish a vendor management office to centralize
These recommendations are a resource to inform not only
the new CIO but also the leadership of the DHA, Wells says.
The report’s authors can provide the organization with a
known cadre of stakeholders to reach out to immediately for
assistance in moving forward.
The DHA report can be accessed online at
contact: Robert K. Ackerman, firstname.lastname@example.org
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