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Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains

GAO-08-954 Published: Jul 28, 2008. Publicly Released: Jul 28, 2008.
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Highlights

Under the National Defense Authorization Act for Fiscal Year 2008, the Department of Defense (DOD) and the Department of Veterans Affairs (VA) are required to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for full interoperability (generally, the ability of systems to use data that are exchanged) and that are compliant with federal standards. The act also established a joint interagency program office to act as a single point of accountability for the effort, whose function is to implement such systems or capabilities by September 30, 2009. Further, the act required that GAO semi-annually report on the progress made in achieving these goals. For this first report, GAO describes the departments' progress to date in sharing electronic health information, developing electronic health records that comply with federal standards, and setting up the joint interagency program office. To do so, GAO reviewed its past work, analyzed agency documentation, and conducted interviews with agency officials.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs To better ensure that the effort by DOD and VA to achieve fully interoperable electronic health record systems or capabilities is accelerated, the Secretaries of Defense and Veterans Affairs should give priority to fully establishing the Joint Interagency Program Office by expediting efforts to (1) put in place permanent leadership, staff, and facilities and (2) make the necessary decisions to finalize the draft implementation plan.
Closed – Implemented
DOD and VA had substantially addressed this recommendation as of early 2010. Specifically, DOD appointed a permanent director to lead the Interagency Program Office (IPO), effective in October 2009, and VA filled the permanent deputy director position, effective in January 2010. At that time, the departments had filled 13 of 14 government staff positions. Regarding the departments' implementation plan for the IPO, the departments produced the DOD/VA Information Interoperability Plan (Version 1.0) in September 2008, which included schedules for establishing the interagency program office; establishing requirements for electronic health record systems; and acquiring, testing, and implementing electronic health record systems.
Department of Defense To better ensure that the effort by DOD and VA to achieve fully interoperable electronic health record systems or capabilities is accelerated, the Secretaries of Defense and Veterans Affairs should give priority to fully establishing the Joint Interagency Program Office by expediting efforts to (1) put in place permanent leadership, staff, and facilities and (2) make the necessary decisions to finalize the draft implementation plan.
Closed – Implemented
DOD and VA had substantially addressed this recommendation as of early 2010. Specifically, DOD appointed a permanent director to lead the Interagency Program Office (IPO), effective in October 2009, and VA filled the permanent deputy director position, effective in January 2010. At that time, the departments had filled 13 of 14 government staff positions. Regarding the departments' implementation plan for the IPO, the departments produced the DOD/VA Information Interoperability Plan (Version 1.0) in September 2008, which included schedules for establishing the interagency program office; establishing requirements for electronic health record systems; and acquiring, testing, and implementing electronic health record systems.

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Topics

Data collectionData integrityData storageData transmissionElectronic data interchangeElectronic health recordsGovernment information disseminationHealth care programsInformation disclosureInformation technologyInteragency relationsInteroperabilityMedical information systemsMedical recordsProgram evaluationRecordsRecords managementReporting requirementsStandardsStandards evaluationStrategic planningInformation sharingProgram goals or objectivesProgram implementation