Auditors found a need for improvement in four areas: information technology systems, in which the two departments collect, store and process information in different systems; business and administrative processes that allow for different billing practices and problems capturing patient workload information; access to military bases, which makes it difficult to balance base security needs with veterans' needs to access medical facilities on base; and medical facility construction, where “misaligned construction planning” hurts efforts to jointly plan facilities that serve VA and Defense beneficiaries.
In addition to addressing those barriers to collaboration, the GAO recommends that the VA and Defense departments require their collaboration sites to develop performance measures that relate to access, quality and costs. According to the study, officials gave reasons why such performance measures don't exist currently at all collaboration sites, including not wanting to “overburden sites with measures and monitoring systems.”
The GAO also suggests that the two departments create a process in which they can identify new—or expanded—collaboration opportunities. “VA and DOD generally concurred with GAO's recommendations and noted steps they are taking to address them,” the report noted.