WASHINGTON – There are several barriers to healthcare collaboration between the Department of Veterans Affairs and the Department of Defense, especially in the area of health IT, a Government Accountability Office report has found (PDF).

The VA and the DOD don’t require that their various joint healthcare projects, known as collaboration sites, use performance metrics to measure their effectiveness, the GAO found, and that’s led to inefficiencies at the agencies’ joint projects in health IT systems, business and administrative processes, access to medical facilities and joint VA and DOD planning for medical facility construction.

In the area of health IT, the GAO wrote, “because VA and DOD collect, store and process health information in different IT systems, providing access to the information needed to best treat those patients has proved problematic...VA and DOD lack IT systems that permit the electronic exchange of comprehensive patient health information, a significant barrier in their collaboration efforts.”

GAO officials visited several jointly-run centers, in Chicago, Mississippi, Honolulu and elsewhere.

At the joint North Chicago Federal Health Care Center, five full-time pharmacists were hired to manually check patient records for allergy information to identify potential interactions between medication prescribed by providers in the VA and DOD systems.

In Biloxi, Mississippi, VA and DOD officials at the Keesler Medical Center told GAO investigators that they shared information by often manually copying or transferring medical information between the VA and DOD IT systems, or even faxing the information. Some clinical staff in Biloxi said they use two side-by-side computers, one for patient records in the VA system and another for records in the DOD system.

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Even where the joint ventures have made IT progress, GAO found, there are significant barriers. At the Tripler Army Medical Center, in Honolulu, Hawaii, VA and DOD officials created an IT system called Janus — named “for the Roman god of gateways and doors” — that lets providers view on a single screen their patients’ records from both VA and DOD systems. Officials and providers told the GAO that Janus has worked well, especially for sharing diagnostic images, allergies and lab results. But Janus is a “read only” tool, and providers can’t add data to the patients’ record in the other agency’s IT system.

Together and separately, the VA and DOD operate some of the largest healthcare systems in the country. Serving about 6 million veterans at 150 hospitals, the VA is requesting $53 billion for the next fiscal year. The DOD, with 9.6 million beneficiaries, is requesting $59 billion for fiscal year 2013 — and is expecting its healthcare costs to reach $92 billion by 2030.

More efficient collaboration, the GAO wrote, “could help reduce duplication and overlap between the
two healthcare systems, potentially saving tax dollars and helping VA and DOD provide more efficient and effective services.”