Medical ADP Systems:

Changes in Composite Health Care System's Deployment Strategy Are Unwise

IMTEC-91-47: Published: Sep 30, 1991. Publicly Released: Sep 30, 1991.

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Pursuant to a legislative requirement, GAO: (1) assessed the status of the Department of Defense (DOD) Composite Health Care System's (CHCS) cost, schedule, performance, and benefits; and (2) identified and evaluated DOD changes in CHCS development, testing, and deployment strategy.

GAO found that: (1) CHCS is a state-of-the-art, integrated medical information system that DOD is developing to improve the timeliness, availability, and quality of patient-care data; (2) as of March 1991, the DOD life-cycle cost estimate was about $1.56 billion, but was subject to change since it did not include such CHCS components as the costs to archive and retrieve patient data and developing a more streamlined method for physicians' entry of orders; (3) DOD has not quantified CHCS benefits; (4) DOD violated DOD directives and statutory restrictions by expending funds to deploy CHCS at 77 medical treatment facilities beyond its test sites without completing operational test and evaluation (OT&E) and obtaining committee approval; (5) due to design and testing difficulties, DOD plans to deploy CHCS without such essential capabilities as the ability to archive and retrieve patient records and a streamlined method for physicians' entry of patient orders; (6) deploying CHCS without archiving is impractical since this function is critical to the system's operational performance and the establishment of a credible cost estimate; and (7) it is unclear whether deploying CHCS without physicians' entry of inpatient orders will be cost-beneficial.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: The Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs and the military departments to refrain from deploying CHCS without the capability to archive and retrieve patient data.

    Agency Affected: Department of Defense

    Status: Closed - Not Implemented

    Comments: A more recent product (GAO/IMTEC-92-54, dated May 20, 1992) contains the same recommendation. Therefore, this recommendation is no longer applicable and should be closed out.

    Recommendation: The Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs and the military departments to refrain from further deployment of CHCS until completion of OT&E and the performance of a cost-benefit analysis that justifies such a deployment.

    Agency Affected: Department of Defense

    Status: Closed - Not Implemented

    Comments: A more recent product (GAO/IMTEC-92-54, dated May 20, 1992) contains the same recommendation. Therefore, this recommendation is no longer applicable and should be closed out.

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