In addition to single patient registration, single sign-on, and orders portability processes and support for the DoD operational readiness system, the contractors also worked on requirements for outpatient appointment scheduling and for producing data on clinical costs and workload needed for financial reconciliation. The requirements for these six capabilities were completed in July 2009 in the form of business requirements documents for each.
The next step was to obtain the $100 million needed to develop the interoperability capabilities, which were supposed to be ready by June 2010, leaving 90 days to ensure that they were stable before the FHCC opening. A proposal to use the JIF mechanism to provide the $100 million was submitted in mid-2009 and it had to be reviewed by the OMB and the congressional appropriations committees before it was approved in August 2009. By this time, the likelihood of completing the set of initial EHR system capabilities by October 2010 was fading, and the departments began to prioritize among them. In July 2009, the DoD notified Congress that the departments were seeking to have three of the key capabilities ready by October 2010: (1) single patient registration, (2) single sign-on with context management for clinical users, and (3) the “first phase” of orders portability for laboratory, radiology, pharmacy, and consultations and referrals. In October 2010, they expected to be just beginning the development of applications to support the Navy’s operational readiness requirements, in the process of developing the requirements for producing financial reconciliation data, and exploring a joint appointment scheduling system (U.S. House of Representatives, 2009). In its annual report, the JEC also reported that single patient registration, single sign-on, and orders portability were the three necessary initial capabilities for implementing the Lovell FHCC, noting that the $100 million in JIF funding was not approved until August 2009, “leaving little time for IT design, development, testing, information assurance, and deployment” (VA/DoD, 2011, p. 41). However, the EA between the departments signed in April 2010 specified that single patient registration, single sign-on, and orders portability would be ready on opening day, as well as documentation of medical and dental operational readiness of recruits and other active duty servicemembers (DoD/VA, 2010, Attachment A).
The funding plan was for the departments to deposit $25 million each in the JIF funds in FY 2009 and another $25 million each in FY 2010, for a total of $100 million. The VA and the DoD began the contracting process using the FY 2009 funding in August 2009. The VA was able to deposit and