GAO claims VA/DOD not ready for EHR interoperability
Monday, July 20, 2009
Congressional investigators, the Defense Department (DOD) and the Department of Veterans Affairs (VA) have strongly differing ideas about how well the DOD and VA are positioned to electronically swap health data ahead of a looming deadline.
Congress has mandated Sept. 30 as the date by which the DOD and VA have to demonstrate interoperability of their respective electronic health record systems.
But the DOD/VA interagency office responsible for making that happen suffers from a lack of leadership and it’s unclear about how close it is to providing that level of functionality, according to officials at the Government Accountability Office (GAO), the investigative arm of Congress.
The office “is not yet effectively positioned to be accountable for the departments' efforts to achieve fully interoperable electronic health record systems,” Valerie Melvin, the GAO's director of information management and human capital issues, told the House Veterans Affairs Committee July 15.
The interagency office has not yet filled key leadership positions, such as the director and deputy director, she said, and it’s not yet fulfilling essential responsibilities in the areas of performance measurement, project planning and scheduling.
Mary Ann Rockey, deputy chief information officer at DOD's Military Health System, disputed Melvin’s testimony, telling the House panel that “the departments currently experience a level of interoperability unsurpassed by other healthcare delivery partners.”
The EHR interoperability achieved by the departments “is a showcase and a precursor for U.S. electronic health data sharing and interoperability initiatives such as the Nationwide Health Information Network,” she added.
Rockey cited as one example the exchange of health data on separated service members through the Federal Health Information Exchange.
“As of May 2009, DOD has transferred health information for over 4.8 million patients to the FHIE data repository,” she said, as well as over 2.5 million pre- and post-deployment health assessments and over 4 million patient messages containing laboratory, radiology, pharmacy, and consult information.
By the September deadline, Rockey said, the DOD and the VA will have achieved “full interoperability of personal health care information...to support the provision of clinical care.”
Six capabilities have been prioritized by the Interagency Clinical Information Board, noted Roger Baker, VA's assistant secretary for information and technology. Sharing social history, questionnaires and self assessment tools, and information to support separation physical exam have been completed. Two others—establishing trusted network gateways and document scanning—are “well underway,” Baker said.
The sixth initiative, which focuses on DOD’s expansion of its inpatient electronic medical record system, is lagging behind.
