Electronic Health Records

Adoption & Implementation News

Lack of Interoperability Dominates VA Health IT Challenges

By Vera Gruessner

- Patient safety and consumer health is of the utmost importance among federal agencies including the Government Accountability Office (GAO) and Veterans Affairs (VA). In a new report GAO shares certain concerns about the VA’s capabilities of ensuring the safety and quality of veteran’s healthcare. In particular, the agency found an issue with health IT challenges like a lack of interoperability among multiple platforms and certain outdated functions in EHR systems.

Health IT Challenges

GAO also claimed that VA has inadequate oversight and accountability when it comes to resolving some issues in a timely manner. Among its various health IT challenges, the agency may have a lack of care coordination among VA and non-VA providers, as the ability to share information quickly and efficiently is lacking among relevant healthcare professionals. Additionally, GAO stresses the importance of implementing effective safety and security measures that safeguard patient data from cyber-attacks.

“We have reported on VA’s failed attempts to modernize its outpatient appointment scheduling system, which is about 30 years old. Among the problems cited by VA staff responsible for scheduling appointments are that the system requires them to use commands requiring many keystrokes and that it does not allow them to view multiple screens at once,” the GAO officials stated in the report. “VA undertook an initiative to replace its scheduling system in 2000 but terminated the project after spending $127 million over 9 years, due to weaknesses in project management and a lack of effective oversight.”

One of the reasons GAO has taken the time to address the health IT challenges and practices at Veterans Affairs is due to a series of infectious disease outbreaks taking place at VA facilities over the last few years. There have been allegations that VA officials did not share information about these issues with the general public. GAO looks to the VA to improve their patient safety and public health measures.

Additionally, the federal agency found that, in 2014, interoperability issues and general difficulty with sharing data led the VA to drop developing a system that would enable electronic storage and access of surgical implant data that included which veteran patients received these devices. This data could be key to ensuring patient safety in the case that the Food and Drug Administration (FDA) may have recalled a medical device.

GAO discussed additional health IT challenges among this organization. The VA lacks EHR systems that allow for effective electronic exchange of healthcare data when military members transition from DOD to VA medical systems. While VA has a goal of increasing interoperability among its EHR technology platforms, this objective has been postponed several times. The lack of EHR interoperability poses risks to veteran’s health and affects the timeliness of treatments.

In an additional report released more than one year ago, GAO also spoke about the importance of enhancing EHR interoperability among VA healthcare systems. Despite the fact that 14 months have passed, GAO continues to find the same problems among Veterans Affairs clinics. Instead of developing an integrated EHR system, VA was focused on developing interoperability among the digital medical record platforms throughout its healthcare facilities. Clearly, Veterans Affairs will need greater oversight and strategies for creating interoperability among EHR systems, as the medical industry moves more closely toward nationwide electronic data exchange.

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