Composite Health Care System:

Outpatient Capability Is Nearly Ready for Worldwide Deployment

IMTEC-93-11: Published: Dec 15, 1992. Publicly Released: Dec 15, 1992.

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Pursuant to a legislative requirement, GAO reviewed the adequacy of the Department of Defense's (DOD): (1) Composite Health Care System (CHCS) operational test and evaluation (OT&E) results; (2) CHCS cost/benefit analysis; and (3) plan for full production and deployment of CHCS.

GAO found that: (1) the outpatient portion of CHCS is not ready for worldwide deployment, since DOD has not performed a complete OT&E of the system, the cost-benefit analysis for CHCS is still unclear and unsubstantiated, and the DOD plan for deploying CHCS lacks specificity; (2) the OT&E that DOD performed was incomplete because it did not include two critical system capabilities; (3) DOD did not follow standard life-cycle cost estimating procedures to produce cost estimates and has not been able to validate estimated CHCS benefits; (4) DOD based its estimates primarily on assumptions of enhanced medical services rather than on empirical data from actual medical treatment facilities; and (5) the DOD plan for deployment does not provide any specific information relating to the deployment schedule or deployment costs, and does not address DOD strategy for configuring and managing the system's hardware and software.

Matters for Congressional Consideration

  1. Status: Closed - Implemented

    Comments: In April 1993, Defense successfully completed a formal OT&E of CHCS Version 4.1--the version of CHCS software that contains both the ability to archive and retrieve patient data and the ability to identify, remove, and prevent the creation of multiple patient records.

    Matter: Congress should not approve CHCS for worldwide deployment until the Secretary of Defense conducts a successful, formal OT&E of the version of CHCS software that contains both the ability to archive and retrieve patient data and the ability to identify, remove, and prevent the creation of multiple patient records.

  2. Status: Closed - Not Implemented

    Comments: GAO and Defense realize that a formal cost/benefit analysis is no longer feasible. DOD is, however, continuously updating its Life-Cycle Cost Estimate, as well as its CHCS Benefits Realization Study. Congress views this action as sufficient, and so does GAO.

    Matter: Congress should not approve CHCS for worldwide deployment until the Secretary of Defense performs a credible cost/benefit analysis.

  3. Status: Closed - Implemented

    Comments: Defense produced a new detailed plan for deployment that addresses the changing circumstances driven by (1) site-by-site cost effectiveness determination, (2) downsizing, (3) evolving plans for military medical support outside the continental United States, and (4) affordability considerations for the period of Fiscal years 1994-1999. The new plan includes initial supply costs, initial training equipment, communications equipment, user devices, system management costs, mid-life upgrade costs, and continued operations and maintenance costs. IN August 1994, Defense provided for our review a copy of its new detailed plan for CHCS deployment. This plan includes (1) detailed information covering CHCS deployment costs, and (2) a deployment plan inlcuding Defense's CHCS configuration management strategy. Defense anticipates that the new plan, while executable, will contiue to evolve due to the rapidly changing strategy for military force levels.

    Matter: Congress should not approve CHCS for worldwide deployment until the Secretary of Defense prepares a detailed deployment plan that includes deployment costs and a configuration management strategy.

  4. Status: Closed - Implemented

    Comments: In 1994, Defense submitted its annual OT&E report to Congress, as well as its fiscal year 1995 Budget Submission report. These reports provided Congress with the following information: (1) In April 1993, Defense completed a formal OT&E of CHCS Version 4.1, which contains the ability to archive patient datat and to identify, remove and prevent the creation of multiple patient records, (2) a formal CHCS cost/benefit analysis is no longer feasible since the necessary data for such an analysis do not exist. However, Defense is continuously updating its CHCS Life-Cycle Cost Estimate and its CHCS Benefits Realization Study, and (3) Defense produced a new deployment plan that addresses the changing circumstances driven by (a) site-by-site cost effectiveness determination, (b) downsizing, (c) evolving plans for military medical support outside the continental United States, and (d) affordability considerations for the period of Fiscal 1994-1999.

    Matter: Congress should not approve CHCS for worldwide deployment until the Secretary of Defense submits a report on its formal OT&E results relating to archiving and multiple patient records, cost/benefit analysis, and detailed deployment plan to the Senate and House Committees on Armed Services.

 

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