Auditors: DOD, VA need measures to track electronic health record progress

The Defense and Veterans Affairs departments are making slow progress in sharing electronic health information because the departments have not developed goals and measures to track their progress toward implementing the full capabilities of interoperable electronic health records, the Government Accountability Office has reported.

For example, DOD and VA exchanged computable pharmacy and drug-allergy data on more than 21,000 shared patients, an increase of 2,700 between June and October 2008, GAO said in a report released Jan 28, However, measuring progress by reporting increases in interoperability has limitations, said Valerie Melvin, director of GAO’s human capital and management information systems issues.

Although DOD and VA have discussed objectives and activities in their plans to increase information sharing, they have not included goals and measures that are characteristic of effective plans, she said. The departments told GAO that their current plans represent their initial efforts to establish interoperability goals.

“Without establishing results-oriented goals, then reporting progress using measures relative to the established goals, the departments and their stakeholders do not have the comprehensive picture that they need to effectively manage their progress toward achieving increased interoperability,” Melvin said.

The departments also have been slow to follow up on GAO’s recommendation in July 2008 report to set up a joint interagency program office, she said.

GAO reports twice a year on the departments’ progress to implement interoperable electronic health records by Sept. 30 under a law that also directed DOD and VA to establish a joint program office. The departments approved a program charter for the office, but have not set it up or filled key positions. The departments had anticipated setting up this office by December 2008, the report said.

“In the continued absence of a fully established program office, the departments will remain ineffectively positioned to assure that interoperable electronic health records and capabilities are achieved by the required date,” Melvin said.

In response, DOD and VA said they would work toward implementing GAO’s recommendations to develop goals for results and measures to track their performance and progress.

The GAO report, Electronic Health Records: DOD's and VA's Sharing of Information Could Benefit from Improved Management, is available here.