From reader DKBerry:

You’d think that buying a common EHR platform and deploying it across all of Defense Department’s medical centers (Army, Navy, Air Force) … that they would have done better.  How did VA succeed where DoD is failing?

Unless the Defense Department addresses weaknesses in project planning and management that have hampered its current electronic health-record system’s capabilities, it risks undermining its new EHR initiatives, according to a Government Accountability Office report (PDF) requested by Sen. Judd Gregg (R-N.H.), the ranking minority member of the Senate Budget Committee.

The report notes how the Defense Department has obligated some $2 billion since 1988 to an EHR system for the 9.6 million active-duty service members, their families and other beneficiaries but has come up short and has scaled back its original expectations for AHLTA. (AHLTA was originally an acronym for “Armed Forces Health Longitudinal Technology Application,” but the department later declared it was no longer an acronym, but a brand.)

After finding AHLTA’s early performance “problematic” in terms of speed, usability and availability, the Department of Defense has sought to acquire a new system known as EHR Way Ahead, according to the report.

The new system, according to the GAO report, “is expected to address performance problems; provide unaddressed capabilities such as comprehensive medical documentation; capture and share medical data electronically within DOD; and improve existing information sharing with the Department of Veterans Affairs,” and has initiated efforts to “stabilize” AHLTA so it can act as a bridge until the system is ready.

The Defense Department has allocated $302 million in its 2011 budget request, according to the report, but has not changed its EHR acquisition process to avoid the same shortcomings it experienced with AHLTA.

Source

Government Health IT ran an interesting article talking about the Department of Defense (DoD) and Veterans Affairs deadline for interoperability of electronic health records. Here’s a short section of the article:

For Navy Capt. Michael Weiner, acting deputy program officer of the Defense Health Information Management System, the two departments have met the relevant interoperability criteria, which were set by the Interagency Clinical Informatics Board, he said.

These included making DoD inpatient discharge notes available to the VA; increasing the number of electronic gateways deployed between the two systems; enhancing the sharing of social history; creating the ability to view scanned documents between systems; and making available DoD periodic health assessments and separation physicals to the VA.

“These were the agreed upon metrics and measures of success and we have achieved them all,” Weiner, told Government Health IT.

However, Rear Adm. Gregory Timberlake, the now retired head of the IPO, committed earlier this year to the complete and computable interoperability of six categories of data by September 30. Not all of these are now shareable in computable form, Weiner acknowledged.

Those six classes of data–for prescriptions, laboratory results, radiology results, and physician, nursing, and therapist notes–were to augment the exchange of drug interaction and allergy information for shared DoD/VA patients previously available. Lab results and radiology results are still not shareable in computable format, according to Weiner.

Of course, we should applaud those who are working on interoperability of EHR software. However, this is a small example of the complexity that’s involved in trying to make healthcare data interoperable. If two organizations that are so closely tied as the DoD and VA are having a challenge sharing their EHR records, imagine what it’s going to be like in the private sector.