The Veterans Affairs and Defense departments' history of problems with program management and accountability as they try to share health information “raises concerns” about the departments' recent decision
to integrate records from their separate systems, the Government Accountability Office has concluded (PDF)
in a study.
That study was part of the written testimony of Valerie Melvin, the GAO's director of information management and technology resources issues, who served as a witness at a House Veterans Affairs Committee hearing on Wednesday. Melvin's testimony reiterated the VA and Defense departments' track record of challenges as the two departments have tried to achieve interoperability of records between their respective information systems in the past 15 years.
Specifically, those include a “persistent absence of clearly defined, measurable goals and metrics, together with associated plans and timeframes” that the GAO auditors say could help the two departments achieve some progress in their efforts.
These problems have come to the forefront after the two departments earlier this month reversed a decision they made in 2011 to develop a single, integrated electronic health record system that could be used across both departments. Instead, the departments have opted to focus on integrating health records separately from the VA and DOD while simultaneously working to improve their own electronic health record systems.
Although the departments expect this decision to help them deliver results sooner and at a lower cost, the GAO study found that deficiencies in strategic planning, investment management and architecture could impede those efforts. On that last point, the departments established the Health Architecture Review Board in February 2012 to provide oversight, approval and decision support for joint VA and DOD programs. But the GAO noted that the extent to which the departments' revised approach to interoperable electronic health records is actually guided by a joint architecture has yet to be seen.
The study also included some recommendations the GAO made to the two departments in a February 2011 report, such as “defining and implementing a process, including criteria that consider costs, benefits, schedule and risks—for identifying and selecting joint IT investments to meet the departments' common healthcare business needs.”