Congress directs Defense and VA to consider common health IT systems

In a report accompanying the final version of the fiscal 2010 Defense Appropriations bill, lawmakers recommended that the Defense and Veterans Affairs departments develop common medical information technology systems to handle laboratory work, pharmacy orders, patient scheduling and transmission of digital radiology images.

While Defense and VA have taken steps to modernize their health IT systems and address interoperability problems, "it appears that both departments are not sufficiently coordinating their efforts, and that lessons learned are not being used to develop an efficient and cost-effective means for data interoperability and information technology modernization," the report stated.

President Obama signed the Defense spending bill on Monday.

Lawmakers acknowledged that Defense and VA have unique IT system requirements, but noted the departments also have common needs that should result in the development of common technology solutions and architecture.

The report directed the Defense/VA Joint Executive Council and the Health Executive Council to identify "opportunities to enhance mutually beneficial service and resources." The panels are to deliver a report to congressional appropriators by Jan. 11, 2010, detailing each department's health IT requirements, identifying those that are unique, justifying why requirements can or cannot be developed jointly, and outlining a path forward.

Defense and VA must coordinate their report with the Health and Human Services Department, which oversees a $20 billion project to modernize electronic health records in the private sector.

"If done correctly and efficiently, the efforts of both departments can be used as an example of how to modernize medical information technology," the report on the Defense spending bill stated.

The appropriations bill recommendations dovetail with language on Defense and VA health IT systems in the fiscal 2010 Defense Authorization Act, which Obama signed on Oct. 28. The law bars the Military Health System from using $192.6 million in its fiscal 2010 health IT budget until Defense meets joint interoperability requirements with the VA and the two departments show progress on development of a joint virtual lifetime electronic record.

A VA clinician who declined to be identified said lawmakers have pushed Defense and VA for a decade to develop common systems. "I'm not going to get excited" about the latest recommendations, the clinician said.

A former military doctor, who also declined to be identified, noted that in 2006, Defense said it would adopt VA's Veterans Health Information System and Technology Architecture (VistA) imaging system, but never followed through.

Both sources said Defense should bear the blame for the lack of common health IT systems in both departments because it opts for its own systems.