Investments in information technology efforts by federal government agencies--including health IT-related investments by the departments of Health and Human Services, Veterans Affairs and Defense--all too often do not meet expectations and essentially become money pits, according to testimony before the House Subcommittees on Government Operations and Information Technology on June 10 by David Powner, director of information technology management issues at the Government Accountability Office.
Powner points out that overall, more than $80 billion annually is invested into IT, and that underperformance of programs stems from a variety of failures at management and executive levels. From October 2009 through last December, his report notes that only 23 percent of the 737 recommendations it has made to the Office of Management and Budget and other agencies to improve management and oversight of IT efforts have been fully implemented.
Efforts discussed by Powner included:
- Healthcare.gov: The project to establish a health insurance marketplace by January 2014 has experienced "significant cost increases, schedule slips and delayed functionality," according to Powner. Various oversight and security issues have been identified. In January, for instance, it was discovered that Healthcare.gov might be violating consumers' privacy rights by giving their personal data--including age, income, ZIP code and various health conditions--to third-party sites embedded on the site.
- VA-DoD health record interoperability: Achieving interoperability between the electronic health record systems of the two agencies has been a challenge for 15 years, according to Powner. The report mentions the scrapped joint EHR venture between VA and DoD, saying that the decision to attempt interoperability between disparate systems "heightens concern" for success. Coincidentally, an amendment was added this week to the Senate's National Defense Authorization Act for Fiscal Year 2016 requiring interoperability between the two agencies' systems.
- VA appointment scheduling system: Efforts to create a technology-driven outpatient appointment scheduling system have been problematic, according to Powner. The VA said last fall it will deploy a new scheduling system by 2017.
In January, the VA Office of Inspector General said the agency lacks the required discipline and accountability to effectively manage its IT projects, despite the development of its Project Management Accountability System, which was built to help the VA manage large, complicated projects in small increments.
And in March, VA's OIG found that the Veterans Health Administration's Chief Business Office violated an appropriations law by misusing $92.5 million for its Health Care Claims Process System--an automated system created to pay private sector providers for services provided to VA beneficiaries.