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Government Accountability Office, Electronic Health Records: VA and DOD Need to Support Cost and Schedule Claims, Develop Interoperability Plans, and Improve Collaboration (GAO-14-302) (Feb. 27, 2014) (full-text).
The Veterans Administration and Department of Defense (DOD) operate two of the nation's largest health care systems, serving approximately 16 million veterans and active duty service members, and their beneficiaries, at total annual costs of over $100 billion. The departments have recognized the importance of developing capabilities for sharing electronic patient health information and have worked since 1998 to develop such capabilities.
In February 2011, the VA and DOD initiated a program to develop a single, common electronic health record system (iEHR) to replace their existing health record systems. This program was to be managed by the IPO and implemented by 2017. However, the departments made significant changes to the program in 2013. The GAO was asked to review the iEHR program. This report (1) describes changes to the program and evaluates the departments' current plans and (2) determines whether the departments are effectively collaborating on management of the program.
The GAO recommends that the VA and DOD develop and compare the estimated cost and schedule of their current and previous approaches to creating an interoperable electronic health record and, if applicable, provide a rationale for pursuing a more costly or time-consuming approach. The GAO also recommends that the departments develop plans for interoperability and ensure the IPO has control over needed resources and clearer lines of authority.