Computer-Based Patient Records: VA and DOD Efforts to Exchange Health Data Could Benefit from Improved Planning and Project Management

The departments agreed with the recommendation and in August 2005 provided documentation (Concept of Operations, Interface Control Document, and Interface Design Description) on the architecture developed for the Clinical/Health Data Repository interface that includes the major elements required in a complete architecture. For example, it defines system requirements and allows these to be traced to the functional requirements, includes the design and control specifications for the interface design, and includes design descriptions for the software.

The departments agreed with the recommendation and in August 2005 provided documentation (Concept of Operations, Interface Control Document, and Interface Design Description) on the architecture developed for the Clinical/Health Data Repository interface that includes the major elements required in a complete architecture. For example, it defines system requirements and allows these to be traced to the functional requirements, includes the design and control specifications for the interface design, and includes design descriptions for the software.

The departments concurred with and have taken actions to address the recommendation. As we reported in June 2006, the departments established project accountability and implemented a joint project management structure. Specifically, the Health Executive Council was established as the lead entity for the project. The joint project management structure consists of a Program Manager from VA and a Deputy Program Manager from DOD to provide day-to-day guidance for this initiative. By creating this management structure the departments have taken a positive step towards achieving the goals of this initiative and developing a point of accountability for future project milestones.

The departments concurred with and have taken actions to address the recommendation. As we reported in June 2006, the departments established project accountability and implemented a joint project management structure. Specifically, the Health Executive Council was established as the lead entity for the project. The joint project management structure consists of a Program Manager from VA and a Deputy Program Manager from DOD to provide day-to-day guidance for this initiative. By creating this management structure, the departments have taken a positive step towards achieving the goals of this initiative and developing a point of accountability for future project milestones.

The Departments of Veterans Affairs and Defense concurred with and implemented this recommendation. The departments have implemented a joint project management structure, consisting of a Program Manager from VA and a Deputy Program Manager from DOD. Additionally, the December 2004 Shared Health Architecture document states that the HEC established the DoD/VA Information Management/Information Technology Working Group to provide programmatic oversight and the DoD/VA Health Architecture Interagency Group, which is a sub-group of the IM/IT Working Group, to facilitate interagency cooperation collaboration on enterprise architecture sharing initiatives between DoD and VA. Collectively, the designated program manager, in conjunction with these groups, provide day-to-day responsibility for project implementation and minimizing the duplication of systems and services. Finally, the Departments are using monthly interim process reviews to provide accountability for their investments in and implementation of the interface capability.

The Departments of Veterans Affairs and Defense concurred with and implemented this recommendation. The departments have implemented a joint project management structure, consisting of a Program Manager from VA and a Deputy Program Manager from DOD. Additionally, the December 2004 Shared Health Architecture document states that the HEC established the DoD/VA Information Management/Information Technology Working Group to provide programmatic oversight and the DoD/VA Health Architecture Interagency Group, which is a sub-group of the IM/IT Working Group, to facilitate interagency cooperation collaboration on enterprise architecture sharing initiatives between DoD and VA. Collectively, the designated program manager, in conjunction with these groups, provide day-to-day responsibility for project implementation and minimizing the duplication of systems and services. Finally, the Departments are using monthly interim process reviews to provide accountability for their investments in and implementation of the interface capability.

In September 2008, the Department of Veterans Affairs, in conjunction with the Department of Defense, produced its initial version of a project plan for achieving the two-way exchange of health information. The plan generally describes the departments' vision, guiding principles, achievements to date, initiatives, organizational roles, and high-level timelines. Additionally, the plan includes information about the authority and responsibility of the interagency office being established to manage the departments' health care information interoperability program, and it contains descriptive information about interoperability standards and generally recognized interoperability levels. Finally, the plan includes milestones for requirements validation, acquisition, testing, and implementation of selected short-term interoperability initiatives. According to DOD and VA officials, subsequent versions of the plan are expected to include additional and more detailed information regarding the departments' efforts to share electronic health information.

In September 2008, the Department of Defense, in conjunction with the Department of Veterans Affairs, produced its initial version of a project plan for achieving the two-way exchange of health information. The plan generally describes the departments' vision, guiding principles, achievements to date, initiatives, organizational roles, and high-level timelines. Additionally, the plan includes information about the authority and responsibility of the interagency office being established to manage the departments' health care information interoperability program, and it contains descriptive information about interoperability standards and generally recognized interoperability levels. Finally, the plan includes milestones for requirements validation, acquisition, testing, and implementation of selected short-term interoperability initiatives. According to DOD and VA officials, subsequent versions of the plan are expected to include additional and more detailed information regarding the departments' efforts to share electronic health information.