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The Departments of Defense and Veterans Affairs need a unified battle plan when it comes to health IT investments, the General Accounting Office says.

In a report issued last week, the GAO blames barriers in IT strategic planning, enterprise architecture and investment management. The two departments are establishing the Virtual Lifetime Electronic Record (VLER) and shared health IT capabilities for the first joint DoD-VA hospital, the James A. Lovell Federal Health Care Center, in North Chicago.

The report noted a number of failures, including:

• Not having explicit plans, goals and timeframes for common health IT requirements for the DoD and VA electronic health record systems.
• Not establishing a clear path for transitioning to future IT architecture.
• Not creating a joint process for approving IT investments based on cost, benefit, schedule and risk for each department.
• Not knowing whether IT capabilities developed for the Lovell hospital are transferrable to other DoD and VA medical facilities.

DoD and the VA, which operate two of the largest health care systems in the country, are too focused on the nuts and bolts of their own EHR modernization to plan for their common requirements, the report says.

GAO recommends revising the departments' joint strategic plan to specifically address common business needs as both EHR systems are modernized; defining future joint health IT architecture and a detailed plan for transition; and developing a robust plan for identifying and selecting joint health IT investments.