GAO Criticizes VA And Defense Department On Health-Care Data Exchange

It says the two agencies have made little progress in determining their approach for achieving two-way exchange of patient health data.
A Congressional auditor is taking to task the departments of Veterans Affairs and Defense for making little progress in determining their approach for achieving the two-way exchange of patient health data.

Linda Koontz, the General Accounting Office's director of information-management issues, told the House Veterans Affairs Subcommittee on Oversight and Investigation on Wednesday that VA and Defense Department officials recognize the importance of an architecture to illustrate how they will electronically link their health systems, but continue to rely on a nonspecific, high-level strategy--in place since September 2002--to guide their development and implementation of this capability as part of the federal government HealthePeople initiative.

VA officials told GAO that an initiative begun this month to satisfy a requirement of a law enacted last year will be used to better define the electronic interface needed to exchange patient health data. But Koontz pointed out that this project is at an early stage, and the departments haven't yet fully identified the approach or requirements for this undertaking. "Given these uncertainties, there's little evidence of how this project will contribute to defining a specific architecture and technological solution for achieving the two-way health data exchange," she said in her prepared testimony. "These uncertainties are further complicated by the absence of sound project management to guide the departments' actions."

Koontz said neither department has the authority to make final decisions binding on the other, and day-to-day oversight of the joint initiative to develop an electronic interface is limited. Progress toward defining data standards continues, the GAO official said, but delays have occurred in the development and deployment of the agencies' individual health-information systems.

The GAO said a critical component of the VA's IT program is its continuing work with the Defense Department to attain the ability to swap patient health-care data and generate electronic records for use by veterans, active military personnel, and their health-care providers. The GAO testified before the subcommittee last November that one-way sharing of data, from Defense to VA medical facilities, had been realized. Two-way sharing of information remains problematic, however. Testified Koontz: "The continued absence of a clear approach and sound planning for the design of this new electronic capability elevates concerns and skepticism about exactly what capabilities VA and DoD will achieve as part of HealthePeople, and in what time frame."

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