NCPA - National Center for Policy Analysis

Electronic Health Records: Outcome-Oriented Metrics and Goals Needed to Gauge DOD's and VA's Progress in Achieving Interoperability

August 27, 2015

Electronic Health Records: Outcome-Oriented Metrics and Goals Needed to Gauge DOD's and VA's Progress in Achieving Interoperability

In the U.S. two of the largest health care systems are the Department of Defense (DOD) and Veterans Affairs (VA).  Combined, these two organizations serve approximately 16 million patients, with operating costs over $100 billion each year. The National Defense Authorization Act (NDAA) for Fiscal Year 2014 established an October 1, 2014 deadline for the DOD and the VA to certify that all health care data in their systems met national standards and were computable in real time.

  • Both the DOD and VA began standardizing existing health data, viewable by clinicians in an integrated format.
  • Longer-term plans are required to meet interoperability standards as both departments did not meet the October 1 2014 deadline, but intend to do so in 2015.
  • By December 31, 2016 both the DOD and the VA are expected by the NDAA to implement modernized software for electronic health records with full standards-based interoperability.

The Government Accountability Office recommended to the DOD, VA and the Interagency Program Office (IPO) to set a time frame for selecting outcome-oriented metrics and to clarify goals relating to assessing and reporting on interoperability between the two systems. The DOD and VA concurred with the GAO's recommendations, but the departments' new plans, including the DOD's plan to acquire a modernized system across military operations and the VA's incremental plan for modernization, indicate that interoperability capabilities will not be completed until 2018.

The IPO noted that identifying standards for the impact of increased interoperability would result in more meaningful measures. A team is currently working on these standards but no time frame has been announced for when the report will be published or when the goals will be incorporated. However, these goals are necessary for the IPO to accurately assess and report on the status of program requirements and to identify areas needing improvement.

Source: Valerie C. Melvin, "Electronic Health Records: Outcome-Oriented Metrics and Goals Needed to Gauge DOD's and VA's Progress in Achieving Interoperability," Government Accountability Office, August 13, 2015.

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