VA and Defense Dept. Electronic Medical Records Can’t Talk to Each Other: $29 Billion Fix Already Abandoned
By John R. Graham • Thursday March 6, 2014 9:02 AM PDT •
A recent survey noted that despite almost $27 billion of federal money spent on implementing electronic health records (EHRs) in the private sector, 70 percent of physicians believe that the adoption of EHRs has not been worth it.
We should not be surprised: The government cannot manage to get EHRs in two of its own closely related departments, Veterans Affairs (VA) and the Department of Defense (DoD), to talk to each other.
According to a new Government Accountability Office (GAO) report, DoD spent $2 billion between 1997 and 2010 on health IT, which now “comprises multiple legacy medical information systems.” The VA has a health IT system that consists of 104 separate computer applications, including:
- 56 health provider apps,
- 19 management and financial apps,
- 8 registration, enrollment, and eligibility apps,
- 5 health data apps,
- 3 information and education apps,
- All of which are customized at all 128 VA sites.
The VA spent almost $600 million between 2001 and 2007 to modernize its health IT systems and estimated a cost of $11 billion to modernize them by 2018. However, the VA abandoned this effort in 2010.
Instead, the two departments got together in 2011 and greed to develop a single, integrated EHR. The new approach would seem to make sense: The VA covers 6.3 million beneficiaries, DoD covers 9.6 million, and 5 million get health benefits from both agencies.
The two departments estimated that the combined effort would cost $29 billion through 2029. Results so far? After two years, both departments abandoned this mega-project and retreated back to their own turfs.
GAO concludes: “In the absence of credible analyses to guide decisions about how to cost-effectively and expeditiously develop the interoperable electronic health record..., VA and DoD have fallen back on the divergent approaches that each department has determined to be best for it.” Furthermore, “...the departments have not developed revised cost and schedule estimates for their new modernization efforts and any additional efforts needed to achieve interoperability between the new systems...”
In other words, abandoning the interoperable EHR in favor of new EHRs for each department may cost more than $29 billion.
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