In early February 2015, two reports were issued criticizing the lack of interoperability between the Department of Defense (DoD) and Veteran’s Administration (VA) health systems.
Both of the reports highlight the fact that the VA and DoD have been working for years on interoperability, with little success. President Obama specifically instructed the agencies to get their acts together back in 2009, at which time the agencies announced that they would create a joint electronic health record (EHR) system in 2011, which was then put on hold in 2013. There's still scant data sharing at this time. The little interoperability that does exist is of limited scope and utility.
In February 2013, DoD and VA officials announced their decision to stop a joint integrated electronic health record and instead place their focus on making their current EHR systems more interoperable. Six years later, or earlier in August of this year, it was announced that Cerner, Leidos and Accenture (News - Alert) were awarded the massive defense contract for the EHR system.
This comes on the heels of a new audit from the Government Accountability Office (GAO), which shows that several deadlines have come and gone with nothing to show for them. As stated in a recent article in Health Data Management, “DoD and VA missed an October 1, 2014, deadline established by Congress in the National Defense Authorization Act (NDAA) for Fiscal Year 2014 to certify that all healthcare data in their systems complied with national standards and were computable in real time.”
A spokesperson mentioned that the new system will be deployed at about 1,000 sites in the U.S. as well as abroad. This deployment will include 55 hospitals and over 600 clinics. However, it will take another six to seven years for all this to take place, even though there is supposed to be a deployment deadline to modernize EHR software by December 31, 2016, which was established by Congress.
It is the responsibility of a DoD-VA Interagency Program Office (IPO) to facilitate efforts in order to identify interoperability standards and coordinate activities designed to increase the sharing of health information. To date, the GAO has revealed that the IPO has neither specified outcome-oriented metrics, nor established related goals.
The GAO report states that “Without ensuring that outcome-oriented metrics and related goals are defined and incorporated into the current approach, the departments and the IPO will not be positioned to assess and report on the status of interoperability-related activities and determine areas that need improvement.”
GAO has recommended that DOD and VA work with IPO in order to:
- Create a time frame for identifying outcome-oriented metrics;
- Define related goals to help gauge and report on the status of interoperability;
- Update IPO guidance to include the metrics and goals identified.
Although both the DoD and VA have agreed with the GAO’s recommendations, it will remain to be seen what type of time frame will actually be established. Many deadlines have already come and gone with little, if anything to show for it. The idea of a shared EHR system is something that will definitely benefit all of our returning veterans; the question remains has to how long they will have to wait.