Pentagon and VA ‘Still Years Away’ from Fully Interoperable Electronic Health Records

The Pentagon and the Department of Veterans Affairs are on course to blow past a congressionally mandated end-of-2016-deadline to fully deploy modernized electronic health record software that works across both agencies’ different health IT systems.

That’s according to a new assessment prepared for lawmakers from the Government Accountability Office.

“Establishing modernized and fully interoperable health record systems is still years away,” Valerie Melvin, GAO director of information technology issues, is expected to say in prepared testimony before two key congressional committees Tuesday.

Full deployment of an upgraded version of the in-house Veterans Health Information Systems and Technology Architecture, known as VistA, isn’t expected to be completed until 2018, according to GAO’s new assessment.

Meanwhile, a massive project at the Pentagon to replace the patched-over Armed Forces Health Longitudinal Technology Application, known as AHLTA, with commercial software is still in the early stages. DOD awarded a $9 billion contract to defense IT firm Leidos and EHR vendor Cerner this summer.

Still, full operational capability for the Defense Healthcare Management System Modernization isn’t planned until the end of 2022.

That’s well past a 2017 deadline originally envisioned by the two agencies when they committed to a now-scrapped plan to develop a common system to be used across both departments.

Lawmakers plan to revisit the disjointed, long-stalled efforts to develop an integrated EHR system during a joint hearing of the House Veterans Affairs Committee and the House Oversight Committee.

In his prepared opening statement, Rep. Mike Coffman, R-Colo., blasted the “erratic history” of DOD-VA EHR integration, which stretches back to at least 1998 and has been marked by numerous false starts and do-overs.

VA and DOD planners settled in 2011 on an ambitious plan to replace the departments’ separate systems and create a single, integrated EHR program to be shared by both entities.

However, in February 2013, citing ballooning cost estimates, officials backed away from plans for creating a common EHR system and instead recommitted to upgrading their respective systems to make them more interoperable. Doing so would be cheaper and yield faster results, officials said at the time.

However, GAO said the two departments never actually proved the scaled-down approach would be less expensive than developing a common system and that efforts to modernize the two agencies’ existing systems are duplicative.

As of this month, neither VA nor DOD have provided GAO with cost comparisons evaluating the different approaches, Melvin will testify.

“On the other hand, with respect to their assertions that separate systems could be achieved faster, both departments have developed schedules that indicate their separate modernizations are not expected to be completed until after the 2017 planned completion date for the previous single system approach,” Melvin is expected to testify.

DOD and VA already missed a congressional deadline last fall for greater electronic sharing between the two departments’ stores of health data -- an initial step for a fully interoperable EHR system.

Christopher Miller, program executive officer, for the Defense Healthcare Management Systems, will tell lawmakers DOD plans to certify that milestone has been met this month -- a year after the initial deadline.

“Today, DOD and VA share a significant amount of health data – more than any other two major health systems,” Miller will say in his prepared testimony. “DOD and VA clinicians are currently able to use their existing software applications to view records of more than 7.4 million shared patients who have received care from both departments.”

Overall, GAO noted several short-term improvements to data sharing in that same vein. For example, VA has expanded functionality of its Joint Legacy Viewer, a tool that allows doctors and nurses to view health data from both departments in a single interface.