The departments of Defense and Veterans Affairs are facing several barriers -- such as inefficiencies in health IT projects -- that are hindering their efforts to effectively coordinate care, according to a recent audit by the Government Accountability Office, Government Health IT reports (Brino, Government Health IT, 10/1).
The audit examined how effectively DOD and VA work together at locations where the two departments deliver care jointly. The auditors identified four areas that require improvement:
- Use of health IT systems to collect, store and process information;
- Business and administrative processes;
- Military base access; and
- Medical facility construction (Zigmond, Modern Healthcare, 9/29).
Health IT-Related Findings
In the audit, GAO identified several inefficiencies in the departments' joint health IT projects.
GAO wrote that "because VA and DOD collect, store and process health information in different IT systems, providing access to the information needed to best treat those patients has proved problematic." The agency added, "VA and DOD lack IT systems that permit the electronic exchange of comprehensive patient health information, a significant barrier in their collaboration efforts."
According to the audit, at some jointly run DOD and VA medical centers:
- Pharmacists manually check patient records to identify potential interactions between drugs prescribed by DOD and VA physicians;
- Health care providers share information by manually copying, transferring or faxing data between DOD and VA health IT systems; and
- Clinical staff use separate computers to compare patient data from DOD and VA health IT systems (Government Health IT, 10/1).
Although a joint graphical user interface called Janus allows clinicians to view DOD and VA health records on a single screen, the tool is read-only and does not allow for data entry, GAO auditors found (Perera, FierceGovernmentIT, 9/30).
GAO recommended that DOD and VA require their jointly run medical centers to develop performance measures related to access, quality and costs. GAO also urged the departments to create a process to identify new or expanded collaboration opportunities.
The audit noted that "VA and DOD generally concurred with GAO's recommendations and noted steps they are taking to address them" (Modern Healthcare, 9/29).