Watchdog finds significant IT problems at joint Defense-VA hospital

Information technology systems at the showcase joint Defense and Veterans Affairs department hospital in North Chicago have experienced so many problems the facility had to hire five full-time pharmacists to manually check prescription data to ensure patient safety, according to a new report from the Government Accountability Office.

The Captain James A. Lovell Federal Health Care Center -- a five-year demonstration project to assess the feasibility of combining Defense and VA hospitals -- includes an integrated health IT system intended to allow clinicians to easily access patient information stored in the VA Veterans Health Information Systems and Technology Architecture or the Defense electronic health record system known as AHLTA.

The Charleston, S.C.-based Space and Naval Warfare Systems Center-Atlantic developed a new tool -- the Application Virtualization and Hosting Environment -- specifically to support integrated health IT at the Lovell hospital, which opened on Oct. 1, 2010, and is designed to serve more than 100,000 veteran and active-duty patients annually, including 40,000 Navy recruits who pass through the Great Lakes boot camp each year. The software was meant to provide "access to the entire suite of critical medical and clinical systems" at the Lovell hospital, including AHLTA, VistA, the VA Computerized Patient Record System and the Defense Composite Health Care System, according to SPAWAR-Atlantic.

In addition, it was supposed to support patient registration in AHLTA and VistA through a single interface; offer a single sign-on for clinicians to both record systems; and grant the ability to order laboratory tests, X-rays and prescriptions from either Defense or VA records, with updates posted in both.

The patient registration and single sign-on capabilities went live last December, according to the GAO report, but the order system has been delayed due to the lack of an integrated project plan from VA and Defense and because of the need for additional on-site testing.

Lovell officials said the lab order system has been on hold indefinitely to correct problems, including difficulty in managing large numbers of automated test orders, GAO found.

Deployment of the prescription order system at Lovell also has been delayed pending high-level review at the two departments, the report stated. As a result, Lovell had to hire the five full-time pharmacists to manually check individual patient records in both AHLTA and VistA and identify possible harmful interactions between drugs prescribed in the two separate systems.

GAO recommended that VA and Defense address the IT problems at the Lovell facility by developing plans that better define the project's scope, cost and schedule.

VA and Defense did not provide GAO with any comments on the IT issues discussed in the report.