The Government Accountability Office has directed the Defense Department to strengthen its efforts to stabilize its current electronic health record (EHR) and to prepare for a future system. Lack of a comprehensive system of sharing health information may other otherwise hobble the department, the GAO warned in a recent report.
So far, DOD has failed to set up all the features of a full EHR in its current system, AHLTA, which continues to be plagued by performance problems.DOD's plans to acquire a commercial EHR system has been dogged by problems, GAO said in the Oct. 6 report.
Problems cited by GAO include DOD's failure to develop a systems engineering plan to guide the technical development of the project, and to set up necessary features and technical requirements that users and operators of the EHR system will need were incomplete, according to the report.
After spending 13 years and $2 billion trying to establish an integrated EHR system, AHLTA has capabilities only for outpatient care and dental care, the GAO noted.
DOD scaled back other capabilities it had originally planned, such as replacement of legacy systems and inpatient care management. In addition, AHLTA users confront speed, usability and availability problems with the portions of the system that have been deployed, GAO said.
DOD has started efforts to improve system performance, enhance functionality and stabilize the AHLTA system through 2015, as a bridge to the new electronic health record system it intends to acquire.
The new system, dubbed the "EHR Way Ahead," is to be a comprehensive, real-time health record that will correct performance problems, provide medical documentation, capture and share medical data electronically within DOD, and improve information sharing with the Department of Veterans Affairs.
As of September, DOD had established a planning office and begun an analysis of alternatives for meeting the new system requirements, according to GAO. Once the analysis is complete in December, DOD expects to select a commercial technical solution for the system and release a delivery schedule.
DOD's fiscal year 2011 budget request included $302 million for the EHR Way Ahead initiative.
Until DOD improves the management of this project, "it risks a continuation of the problems it has already experienced, which could again prevent DOD from delivering a comprehensive health record system," GAO said in the report.
In a response letter to GAO, Dr. George Peach Taylor, Jr., the acting assistant secretary of Defense for Health Affairs, said that DOD will follow GAO's recommendations.
Among them, DOD will maintain a comprehensive plan for the EHR system, such as scope, cost, schedule and risks; include EHR users in developing the system; and develop a plan for improving user satisfaction that prioritizes improvements.
