According to a Government Accountability Office report, the Defense and Veterans Affairs departments need to better plan for improved connections between their two healthcare organizations and information technology systems.
The two departments have labored for more than a decade
to achieve interoperability between their once-related electronic health-record systems, often producing less-than-satisfactory results
, according to multiple previous GAO reports.
Those efforts toward Defense Department and VA connectivity were given an added urgency in 2009 by President Barack Obama, who called for creating a virtual lifetime electronic record by 2012 that can seamlessly track the healthcare needs of active-duty military personnel and veterans.
Congress directed the GAO to "identify any barriers that DOD and VA face in modernizing their EHR systems to jointly address their common healthcare business needs and identify lessons learned from the Defense Department's and the VA's efforts to jointly develop (a virtual lifetime electronic record) and to meet the healthcare information needs" of the new James A. Lovell Federal Health Care Center in North Chicago, Ill., The center, named for the Navy captain and astronaut, opened in December and is an administrative consolidation of the Naval Health Clinic, Great Lakes and the nearby 435-bed North Chicago VA Medical Center.
The Navy clinics, the hospital and a new $130 million outpatient clinic, serve active-duty Navy personnel and veterans under a single administrative structure, the first of its kind, according to the departments. The VA hospital and outpatient clinic use the VA's VistA EHR, while the Navy clinic uses the military's AHLTA ambulatory EHR.
Despite their current levels of collaboration, the Defense Department and the VA "have not sufficiently established" a strategic plan, an enterprise architecture and an IT investment management process, all of which are critical to effectively modernizing major IT systems, according to 78-page report (PDF)
"For example,” the report notes, "the departments have not defined how they intend to transition from their current architecture to a planned future state. Furthermore, DOD and VA have not established a joint process for selecting IT investments based on criteria that consider cost, benefit, schedule and risk elements, which limits their ability to pursue joint health IT solutions that both meet their needs and provide better value and benefits to the government as a whole."
One of the factors contributing to the development of these barriers, the report continued, was "the departments' decision to continue with their existing efforts—VLER, separate electronic health-record modernizations and developing IT capabilities for the FHCC—rather than determining the best approach to jointly addressing their common requirements."