DOD struggles with medical e-records system

Introduction

The Department of Defense (DOD) has struggled since 1988 to establish a comprehensive medical records database for the 9.6 million service members and families it covers under its behemoth health insurance coverage. Over the years, the DOD has dumped money, time, and additional resources into creating an electronic health record system to coordinate military medical facilities around the world.

Yet the initiatives consistently fall short of goals, and the billions of taxpayer dollars cannot overcome systematic management hurdles plaguing the project, according to a new Government Accountability Office report.

The watchdog confirms what the Pentagon’s inspector general has previously reported: the system lacks usability, speed, and availability for the 135,000 health care providers who access the records at military hospitals and clinics worldwide. Over the last 13 years, the DOD has spent $2 billion on the project.

Considering the scale and scope of the Pentagon’s health care for soldiers and their families, a coordinated system of medical, dental, and vision records is necessary when treating patients around the globe.

Yet year after year, the e-records system has fallen short, the GAO said. Medical professionals struggle to use it because the system is too slow when patients are being examined, and is sometimes inaccessible. “Using the system at the time of the encounter would take attention away from the patient for unacceptable periods of time,” the GAO said. A 2006 report by the Pentagon’s inspector general found that officials had underestimated the complexity of integrating products with e-records.

The GAO report found that weak management crippled the ability of the e-records program to deliver the full spectrum of services expected. The report also found that the program office failed to maintain a management plan, systems engineering plan, and had no plan to improve user satisfaction.

FAST FACT: The Pentagon spends about $49 billion annually providing health care for soldiers and their families, and employs about 135,000 doctors, nurses, therapists, and other health care workers.

Other new watchdog reports released by the Government Accountability Office (GAO), various federal Offices of Inspector General (OIG), and other government entities:

FINANCE

* IRS is training employees for eventual adoption of International Financial Reporting Standards by U.S. publicly-traded companies, replacing GAAP. The accounting change is intended to help investors more easily compare U.S. and foreign companies’ financial results (OIG).

* About 12 percent of poor families improperly received loans under the $1 billion stimulus injection for USDA’s Rural Housing Service because of incomplete loan underwriting and documentation (OIG).

NATIONAL SECURITY

* The U.S. cybersecurity coordinator should set milestones and assign specific responsibilities to agencies to carry out more than a dozen policy recommendations made one year ago. The delay is due in part to a lengthy vacancy in the cybersecurity coordinator job on the National Security Council (GAO).

MISC.

* Social Security Administration has spent much less than the $90 million provided by the stimulus law for administering a one-time $250 payment to certain Social Security beneficiaries, and the agency may return as much as $50 million to the U.S. treasury (OIG).