Deadline Looms for VA-DOD Interagency Office on Military Electronic Health Records

Washington, D.C. – On Tuesday, July 14, 2009, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted a hearing to examine the progress of electronic health record interoperability between the Department of Veterans Affairs (VA) and the Department of Defense (DoD). 

Section 1635 of the National Defense Authorization Act of 2008 mandated the establishment of an Interagency Program Office (IPO) to act as the single point of accountability in the rapid development and implementation of the electronic record systems that allow for full interoperability of personal health care information between the DoD and VA.  The deadline to achieve this interoperable health record is September 30, 2009. 

“As the September 30 deadline for electronic health record interoperability approaches, it is imperative to ensure that both the DOD and VA are organized and working together to deliver a comprehensive system that will modernize and simplify record sharing between Departments,” Chairman Mitchell said.  “As a growing number of men and women return from the battlefields in Iraq and Afghanistan with more complicated and more severe wounds, it is time to make their care and treatment easier.  It is time for us to improve upon a system that will ensure the best and most complete care, efficient benefits delivery, and a seamless transition back into civilian life.”

Valerie Melvin of the Government Accountability Office (GAO) discussed the progress in setting up the IPO as well as apparent challenges that prevent the office from fulfilling key information technology management responsibilities.  GAO stated in a March 2009 report that “VA and DoD have succeeded in increasing their ability to share and use health information.  In particular, they are sharing pharmacy and drug allergy data in computable form—that is, in a format that a computer can understand and act on….the departments are now exchanging this type of data on over 27,000 shared patients—an increase of about 9,000 patients between June 2008 and January 2009.” 

GAO states that the departments still have more to do: not all electronic health information is yet shared, and although VA’s health data are all captured electronically, information is still captured on paper at many DoD facilities.  Further shortcomings include inadequate tools for performance measurement, project planning, and scheduling.  Currently, according to GAO, IPO has developed performance goals for only one of six identified interoperability objectives.   

The biggest challenge with meeting the mandated deadline is the clarity and interpretation of the language “fully interoperable.”  GAO defines in their March 2009 report that “interoperability is the ability of two or more systems or components to exchange information and to use the information that has been exchanged.”  Rear Admiral Gregory Timberlake, Acting Director of the Interagency Program Office, testified that the September 30, 2009 deadline for an interoperable health record would be met.  Subcommittee members expressed disappointment that the IPO would only be capable of interoperability, and would not be ready to execute “full interoperability” by the looming deadline. 

“Although progress has been made toward our goal of shared electronic health records, I am disheartened at how little has been done,” said Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs.  “Today’s testimony leads me to believe that the Interagency Program Office may meet the deadlines of the mandate, but clearly the spirit of the law has been ignored.  Of particular concern is the inability to fill key leadership positions within the IPO.  This is a leadership issue and must be given immediate attention.”      

Witness List

Panel 1:

·       Valerie C. Melvin, Director, Information Management and Human Capital Issues, U.S. Government Accountability Office

Panel 2:

·       Rear Admiral Gregory Timberlake, SCHE, USN, Acting Director, DOD/VA Interagency Program Office

Accompanied by:

o       Cliff Freeman, MA, MS, Deputy Director, DOD/VA Interagency Program Office

·       Mary Ann Rockey, Deputy Chief Information Officer, Military Health System, U.S. Department of Defense

Accompanied by:

o       Captain (Select) Michael Weiner, MC, USN, Chief Medical Officer, Defense Health Information Management System, U.S. Department of Defense

·       Honorable Roger W. Baker, Assistant Secretary for Information and Technology, U.S. Department of Veterans Affairs

Accompanied by:

o       Paul A. Tibbits, M.D., Deputy Chief Information Officer, Office of Enterprise and Development, U.S. Department of Veterans Affairs

o       Scott Cragg, Executive Director and Program Manager, Virtual Lifetime Electronic Record Program, U.S. Department of Veterans Affairs

o       Douglas E. Rosendale, DO, FACOS, Enterprise System Manager for Joint Interoperability Ventures, Office of Health Information, Veterans Health Administration, U.S. Department of Veterans Affairs

o       Ross D. Fletcher, M.D., Chief of Staff, Washington, DC, Veterans Affairs Medical Center, Veterans Health Administration, U.S. Department of Veterans Affairs

Prepared testimony for the hearing and a link to the webcast from the hearing is available on the internet at this link: http://veterans.house.gov/hearings/hearing.aspx?newsid=427.