Records Management

GAO to DOD, VA on electronic health records: Prove it

The Defense and Veterans Affairs departments need to prove that their separate quests to develop interoperable electronic health records are more cost-effective than a combined approach, or at least show why a more expensive approach will be more effective, according to a Government Accountability Office review of the programs.

The departments last year abandoned a joint approach to develop an integrated electronic health record, or iEHR, following a 30-day review and Defense Secretary Chuck Hagel’s assertion that “a competitive process is the optimal way to ensure we select the best value solution for DOD.”

After dropping the joint effort, VA said it would modernize its VistA health information system and DOD said it would turn to commercial software to replace its AHLTA health records system. And both said that the systems would be interoperable with each other.

In January, for example, the department issued a solicitation looking for industry ideas on building interoperable records. And in February, DOD made records in its Health Artifact and Image Management Solution — in place for service members discharged since Jan. 1 — available to VA.

VA plans to have its new system operating at two locations by September 2014 and DOD is aiming for the end of fiscal 2016 for its new system, GAO noted. The question, however, is whether these approaches are better. “VA and DOD have not substantiated their claims that the current approach will be less expensive and more timely than the single-system approach,” GAO’s report said.

Interoperable health records that would seamlessly follow service members as they transition from active-duty to veteran status have been a holy grail for DOD and VA since 1998. The two organizations serve about 16 million veterans, active duty service members and beneficiaries at a cost of over $100 billion a year, and have long seen the advantage of integrated records. A number of efforts — from the Government Computer-Based Patient Record to attempts to link the departments’ data repositories to the currently abandoned joint effort, which was started in February 2011 with a completion target of 2017 — have fallen short.

Current efforts may be showing progress, but GAO said DOD and VA haven’t justified their decision to drop the iEHR program by showing a cost and schedule analysis of the separate programs.

GAO recommends that the departments develop those cost and schedule estimates and compare them to iEHR and other past efforts. If the current efforts are more expensive or time-consuming, GAO wants DOD and VA to explain why they’re worth pursuing.

About the Author

Kevin McCaney is a former editor of Defense Systems and GCN.

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