The inability of the U.S. Department of Veterans Affairs and the Department of Defense to share healthcare data electronically has become such a significant concern that the Government Accountability Office (GAO) has added the problem to its list of "high risk" areas.
The list, updated biennially, flags government systems and programs that are particularly vulnerable to fraud, waste, abuse, mismanagement or transformation. The most recent list, presented to Congress on Feb. 11, has added "managing risks and improving VA healthcare" and "improving management of IT acquisitions and operations" to its update. Both new high risk areas cite the lack of data sharing between the VA and DoD as a major problem deserving of increased attention.
"The two departments have engaged in a series of initiatives intended to achieve electronic health record interoperability, but accomplishment of this goal has been continuously delayed and has yet to be realized," the GAO says. "The ongoing lack of electronic health record interoperability limits VA clinicians' ability to readily access information from DOD records, potentially impeding their ability to make the most informed decisions on treatment options, and possibly putting veterans' health at risk."
The two agencies had been working on data sharing projects for 15 years, and in 2011 committed to a new integrated EHR, but abandoned that plan in 2013 in favor of integrating two separate systems. The GAO notes that this change in direction has heightened concern whether this latest initiative will be successful.
A new report issued by the Center for a New American Security on reforming the military's healthcare system echoed the GAO's concern about the lack of interoperability between the VA and the DoD, saying the latter's current plan to award one contract to one "winner" may lead to "vendor lock and health data isolation."
The Defense Health Agency has indicated that interoperability with the VA remains a priority even though current initiatives have run into road bumps. Its contract for a new EHR is expected to be announced within the next few months.