Watchdog: DOD and VA Need Better Metrics for Health Record Interoperability

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The two groups, overseen by the Interagency Program Office, don't have a good way to measure progress on interoperability, according to GAO.

The departments of Defense and Veterans Affairs don’t have sufficient metrics to demonstrate their progress toward health systems that communicate with each other, according to a new report.

In a recent audit, the Government Accountability Office concluded DOD, VA and the Interagency Program Office overseeing the effort to make their electronic health record systems interoperable "lack results-oriented (i.e., objective, quantifiable and measurable) goals."

DOD recently announced it was awarding Leidos a multibillion-dollar contract -- with an expected value of $9 billion over 18 years -- to rebuild its electronic health record system; VA is currently modernizing its existing system.

Among goals for the health system update include making interoperable electronic health record platforms -- primarily because veterans, military personnel and their families "tend to be highly mobile and may have health records residing at multiple medical facilities within and outside the United States" -- as well as interoperability standards for other federal health care programs

But without proper metrics, the IPO will not be able to assess the status of the two agencies' efforts, or the impact of those efforts on the quality of health care, GAO concluded. Though IPO has previously suggested tracking some metrics such as "the number of laboratory reports and the number of consultation reports exchanged from DOD to VA" or the "number of patient queries by providers from both departments," its guidance doesn't explicitly identify metrics to show the improvement of "health care services resulting from the departments’ interoperable capabilities."

And as of late May 2015, IPO didn't have a time frame for when those metrics would be completed and written into the guidance, GAO found. 

GAO recommended DOD and VA secretaries, along with the IPO, draw up a timeline for identifying metrics, update IPO's metrics guidance, and better define measurement goals. 

VA Chief of Staff Robert Nabors wrote in a statement that VA "generally agrees" with GAO's conclusions and generally concurs with the recommendations, according to comments included in the report.

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