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GAO: DoD, VA Need to Improve Interoperability Efforts

October 30, 2015
by Rajiv Leventhal
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The Departments of Veterans Affairs (VA) and Defense (DoD) did not establish that all healthcare data in their systems complied with national standards and were computable in real time, according to a report from the Government Accountability Office (GAO).

As GAO reported in August, DoD and VA, with guidance from the Interagency Program Office (IPO), tasked with facilitating the departments' efforts to share health information, have taken actions to increase interoperability between their existing electronic health record (EHR) systems. These actions have included work on near-term objectives such as standardizing certain health data and making them viewable by clinicians in both departments in an integrated format, as well as long-term goals such as modernizing their respective EHR systems. IPO issued guidance outlining the technical approach for achieving interoperability between the departments' systems.

Nonetheless, the departments did not establish that their electronic health data complies with national standards by the Oct. 1, 2014 deadline that they were given, GAO attests. Furthermore, GAO says, the departments do not plan to complete the modernization of their EHR systems until well after the December 2016 statutory deadline by which they are to deploy modernized EHR software while ensuring full interoperability. Specifically, VA plans to modernize its existing system, while DoD plans to acquire a new system; but their plans indicate that deployment of the new systems with interoperable capabilities will not be complete until after 2018.

Indeed, in late July, it was announced that a team led by Cerner Corp. and Leidos won the bid to modernize the massive Department of Defense Healthcare Management Systems Modernization (DHMSM) EHR contract. The new contract is set to cover more than 9.5 million Defense Department beneficiaries and the more than 205,000 care providers that support them. The contract was reported to be in the $9 billion range. However, fully operational capability isn’t planned until the end of 2022, long after what was originally discussed.

The report comes in addition to GAO testimony delivered earlier this week to the House Committee on Oversight and Government Subcommittee on Information Technology for a hearing on EHR interoperability between the DoD and VA. During the hearing, Valerie Melvin, GAO director of information technology issues, said, “Establishing modernized and fully interoperable health record systems is still years away.”

IPO officials said that work was ongoing to develop more meaningful interoperability measures of progress, but the office had not established a time frame for completing this work or incorporating the outcome metrics and associated goals into its guidance. GAO concluded that “without defining outcome-oriented metrics and related goals and incorporating them into their current approach, the departments and the IPO will not be in a position to effectively assess their progress toward further achieving interoperability and identifying the benefits that their efforts yield.”

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