VA, DoD must pick up the pace of interoperability

The pressure is mounting on the U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) to share health records electronically--if only the agencies will take the hint.

Not one, but two reports were issued last week decrying that the lack of interoperability is a serious problem for this country.

The first is the Government Accountability Office's (GAOs) addition of two new items to its list of "high-risk areas," those government programs particularly vulnerable to fraud, waste, abuse, mismanagement or transformation. The two additions-- "managing risks and improving VA healthcare" and "improving management of IT acquisitions and operations"--both flag the lack of data sharing between the VA and DoD as a major concern deserving of increased attention from Congress and the executive branch. VA/DoD data sharing now ranks as a problem with such other notable high-risk areas such as Medicare and Medicaid, improving the Postal Service, strengthening the Department of Homeland Security and food safety.

The second is a report from the Center for a New American Security on reforming the military health system, authored by three experts--including one former member of the Joint Chiefs of Staff. That report calls the DoD's EHR history "tortured," and its current plan to purchase a proprietary commercial EHR a bad idea that will lead to "vendor lock and data isolation." They recommend that DoD instead work on its data integration with the VA and choose an extensible, flexible EHR platform.

"Given the fast pace of technology changes, we hope that DOD will not repeat the mistaken multi-billion dollar decision that will hold it captive to the innovations of any single company or the services of a solitary vendor," the authors state. "Because of how enterprise systems are deployed, a poor selection at the first stage will inexorably lower performance and restrict enhancement choices for more than a decade."

Both reports highlight that the VA and DoD have been working for years on interoperability with little success. President Barack Obama specifically instructed the agencies to get their acts together back in 2009; the agencies announced they'd create a joint EHR in 2011 and then shelved the idea in 2013. There's still little data sharing; the scant interoperability that does exist is of limited scope and utility.

It's been well established that the electronic health records of our service men and women should be seamless, whether one is actively serving or a veteran. Moreover, many of these people, who put themselves in harm's way, have more medical needs than the average American.

The time for excuses and kicking the can down the road is over. Hopefully these two reports will be the catalyst for policymakers and lawmakers to light a fire under the VA and the DoD to make this happen. The continued lack of data sharing between these two agencies can have enormous financial and safety ramifications. Surely this is something that everyone can agree on.

The GAO itself notes in its report that moving an issue to the high-risk list leads to increased attention and progress toward resolving the problem.

Let's hope that the GAO is right.  - Marla (@MarlaHirsch and @FierceHealthIT)

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