5 problematic HIT projects costing the government billions

Cost overruns and missed deadlines for several federal agency health technology projects are costing the government "billions of dollars," according to a Government Accountability Office report focusing on the inefficiency of agency IT initiatives published Thursday.

The report, which refers to the projects as "challenges" or "failures," also reveals that a public website developed by the Office of Management and Budget (OMB) to track technology spending--the IT Dashboard--is plagued with inaccurate cost and schedule information.

"Information technology should enable government to better serve the American people," the report's authors wrote. "However, according to OMB, despite spending more than $600 billion on IT over the past decade, the federal government has achieved little of the productivity improvements that private industry has realized from IT. Too often, federal IT projects run over budget, behind schedule or fail to deliver promised functionality. In combating this problem, proper oversight is critical."

Problematic health IT projects identified by the authors include:

  • The U.S. Department of Veterans Affairs' Health Information Systems and Technology Architecture--Foundations Modernization (VistA-FM): Created to address the need to transition VA's electronic health record system to a new architecture. The program cost $1.9 billion, and was terminated in October 2010.
  • The VA-U.S. Department of Defense Integrated Electronic Health Record (iEHR): Two  Congressional bills unveiled this month are designed to spur integration between the two agencies' systems, which has been an ongoing challenge for nearly two decades, the report's authors said. The idea of creating a joint EHR from scratch was nixed this past February, a decision that was met with considerable criticism. An amendment to the House National Defense Authorization Act, passed last month, would increase oversight of the iEHR process.
  • DoD-VA's Federal Health Care Center (FHCC): Despite spending $122 million to create a medical facility in Chicago to serve both departments' patients while operating under a single line of authority, none of this project's IT capabilities were implemented as planned upon the facility's opening in October 2010.
  • DoD's Armed Forces Health Longitudinal Technology Application (AHLTA): This project--which involved DoD acquiring its own EHR system--cost $2 billion over 13 years, but speed, usability and availability all have been problematic for users, the report's authors said. Among other problems, medication documentation issues in the system have kept doctors from successfully tracking drug use by soldiers, hindering efforts to crack down on abuse.
  • VA's Scheduling Replacement Project: Despite spending $127 million over nine years to modernize an outpatient system more than 25 years old, the VA terminated this project in September 2009.

To learn more:
- here's the report (.pdf)