The Defense Department has failed to adequately develop blood information systems over the past 13 years of war in Afghanistan and Iraq despite spending a total of $289 million, the Pentagon inspector general reported last week.
The latest review, which is a follow-up to an October 2001 IG report, said the Armed Services Blood Program Defense Blood Standard System – or DBSS – has miscounted the inventory of blood products, including those used in combat, and that the Pentagon has failed to develop a single, integrated portfolio for the blood information technology system.
The officials in charge of the effort “could not demonstrate after 13 years that officials implemented the necessary actions to mitigate the identified system problems as agreed,” in 2001,” Amy Frontz, principal assistant inspector general for auditing, wrote in the Oct. 23 cover letter to Jonathan Woodson, the assistant secretary of defense for health affairs, accompanying the report.
In 2001, the IG first recommended DBSS be replaced with a new system – the Enterprise Blood Management System, or EBMS -- which would help eliminate inventory problems as well as the requirement that data be manually entered into the system.
The IG, in its current report, said the donor portion of EBMS is a work in progress, and though it witnessed a demonstration of its capabilities “we could not substantiate the system’s capabilities.”
The current report added, “There are no specifics as to how the donor system will facilitate real‑time data and track blood product inventory in the Interface Control, Software Requirements Specification, and the Preliminary Design Review/Critical Design Review documents,” all requirements for DOD IT systems. “Therefore, the donor system is not far enough along the acquisition process to determine whether its requirements will address or mitigate the in‑transit blood product inventory problems,” the report said.
The IG recommended the Defense Health Agency fix the inventory problems encountered 13 years ago and that the blood bank capabilities interface with the Composite Health Care System database, which manages Defense medical lab systems.
In 2006, the Military Health System acquired three different IT capabilities for managing blood, but they did not interface with each other and as a result Defense missed opportunities to leverage efficiencies. The IG recommended these interfaces be developed as interoperable parts of an IT portfolio, according to the report.
Air Force Lt. Gen. Douglas Robb, director of the Defense Health Agency, said in his reply to the IG report that managers of the blood program will ensure that double counting of inventory will no longer occurs in EBMS.
Robb said the agency will also evaluate how blood-management systems would benefit from the integrated IT portfolio approach.