The money the DOD is spending on its Military Health System (MHS) and a plan to develop an electronic health record system does not justify the work being done on the projects, said U.S. Comptroller Gene Dodaro in recent testimony before the Senate Committee on Homeland Security and Government Affairs. The Government Accountability Office published the testimony in a report this week.
Costs for the DOD MHS more than doubled in nine years--from $19 billion in fiscal-year 2001 to $49 billion in 2010--and are expected to increase even more, to $62 billion by 2015, Dodaro said.
Moreover, the project is plagued by decentralized, nebulous management--responsibilities for the system are distributed among several DOD organizations without central command authority nor a single person who holds accountability for it.
And the department still has not consolidated very obviously common administrative, management, and clinical functions within the system, which would help it save money, according to Dodaro.
The comptroller also criticized lack of cooperation between the DOD and the Department of Veterans Affairs (VA) on aligning their electronic health systems in his testimony.
Because of the nature of their work, the departments must share massive amounts of patient data and also have similar healthcare business needs. While there has been some collaboration between the two, both decided to build EHR systems independently of the other. That decision likely will end up costing billions for both departments with duplicative results, Dodaro said.
The DOD has obligated about $2 billion over 13 years for its Armed Forces Health Longitudinal Technology Application, while the VA said it already spent nearly $600 million from 2001 to 2007 on eight projects as part of its own EHR system, the Veterans Health Information Systems and Technology Architecture. The department has estimated it will cost $11 billion total to complete the system by 2018.
This situation is clearly ripe for a reduction in duplication, Dodaro observed in his testimony. "Reduced duplication in this area could save system development and operation costs while supporting higher-quality health care for service members and veterans," he said.
To be fair, the DOD and VA are trying to collaborate on aspects of their EHR systems to reduce overlapping efforts. This includes the development of a joint standard for sharing patient data.
Eliminating duplicative programs across the board is a key priority for the Obama administration, which has suffered budget cuts and is trying to reduce spending. IT in particular is a target for the White House, which has enacted a comprehensive IT reform plan with a reduction in duplicative IT spending as one of its main goals.
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