Electronic Health Records:

Program Office Improvements Needed to Strengthen Management of VA and DOD Efforts to Achieve Full Interoperability

GAO-09-895T: Published: Jul 14, 2009. Publicly Released: Jul 14, 2009.

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Valerie C. Melvin
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For over a decade, the Department of Veterans Affairs (VA) and the Department of Defense (DOD) have been working on initiatives to share electronic health information. To expedite their efforts, Congress mandated in the National Defense Authorization Act for Fiscal Year 2008 that VA and DOD establish a joint interagency program office to act as a single point of accountability in the development of electronic health records systems or capabilities that allow for full interoperability (generally, the ability of systems to exchange data) by September 30, 2009. In this statement, GAO summarizes findings from its upcoming report, focusing on progress in setting up the interagency program office and the departments' actions to achieve fully interoperable capabilities by September 30, 2009. To do so, GAO analyzed agency documentation on project status and conducted interviews with agency officials.

VA and DOD have made progress in setting up the interagency program office; however, the office is not yet effectively positioned to be accountable for the departments' efforts to achieve fully interoperable electronic health record systems or capabilities. The departments have taken the important steps of completing personnel descriptions and hiring necessary staff to perform the office's functions, but key leadership positions (for the Director and Deputy Director) continue to be filled on an interim basis. In addition, the office has established a charter and begun to demonstrate responsibilities outlined within this document. Nonetheless, the office is not yet fulfilling key information technology management responsibilities in the areas of performance measurement, project planning, and scheduling--all of which are essential to establishing the office as a single point of accountability for the departments' interoperability efforts. VA and DOD continue to take steps toward achieving full interoperability by the September deadline. In this regard, the departments have achieved planned capabilities for three of six interoperability objectives (see table) that they identified to meet their data sharing needs--refine social history data, share physical exam data, and demonstrate initial network gateway operation. For the remaining three objectives--expand questionnaires and self assessment tools, expand DOD inpatient medical records system, and demonstrate initial document scanning--the departments have partially achieved planned capabilities, with additional work needed to fully meet clinicians' needs for health information.

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