October 4, 2022

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Joint audit finds DOD, VA fell shorter on EHR interoperability

A joint report launched this 7 days from the Workplaces of Inspector Common for the Departments of Defense and Veterans Affairs discovered that the agencies had not taken all essential steps to realize interoperability of affected individual care information when they deployed the Cerner digital well being document method and introduced the Joint Wellbeing Info Trade.  

“Acquiring interoperability between the DOD, VA, and exterior healthcare providers by way of the deployment of a solitary EHR procedure is critical because healthcare suppliers will have the capability to securely transfer and share overall health care facts for the nation’s 9.6 million DoD armed forces associates, dependents and retirees, and 9.21 million enrolled consumers,” study the report.  

“VA appreciates the suggestions,” stated VA spokespeople in reaction to requests for comment from Health care IT Information. “We take into account all options for enhancement in VA’s technique to making sure a complete digital health and fitness record that accomplishes a seamless changeover from armed service service to veteran status.   

“We will continue to function closely and efficiently with the Federal Digital Wellbeing Report Modernization Place of work and our DOD colleagues on our joint energy,” the spokespeople continued.

Requests for remark from DOD and the FEHRM Application Workplace were being not returned by push time.  

WHY IT Issues  

As outlined in the audit report, Congress directed the DOD and VA to enable interoperability of affected individual wellbeing information and facts amongst the departments as component of the FY 2008 Nationwide Protection Authorization Act. Additional requirements have been instituted as element of the FY 2014 NDAA and the FY 2020 NDAA.  

To meet those people interoperability requirements, the companies contracted with Cerner in 2015 (for DOD) and 2018 (for VA), with ideas to deploy its EHR through healthcare services over the subsequent 10 years.  

The DOD and VA also proven the FEHRM Plan Office to supply direction and oversight to corporations rolling out the Cerner EHR.  

“The FEHRM Application Office’s key mission is to operate closely with the DOD and VA to implement a single, interoperable federal EHR and establish and retain a comprehensive patient file that would greatly enhance patient care and health care provider usefulness,” browse the joint audit report.   

“Moreover, the FEHRM Plan Business applied the Joint Well being Information and facts Exchange to improve the capability of the Departments to securely trade health care details with extra than 15,000 external health care providers,” famous the auditors.   However, the watchdogs found that the DOD and VA “did not take all the actions wanted to obtain interoperability.”  

Specially, said the OIGs, the agencies did not:

  • Continuously migrate affected person health care data from the legacy electronic wellbeing treatment methods into Cerner to generate a single, entire affected person EHR
  • Create interfaces from all health care gadgets to Cerner Millennium so that patient health care info will automatically upload to the system from all those gadgets
  • Be certain that end users were granted entry to Cerner Millennium for only the facts required to conduct their duties  

The OIGs pointed the finger at FEHRM for this, declaring that it did not develop and employ a strategy to reach interoperability needs or take an lively job to control the program’s good results.  

“As an alternative, FEHRM System Business officials minimal their function to facilitating conversations when disputes arose amongst the DOD and the VA, and would only provide route if the Departments described a difficulty,” explained the report.   

“Since the FEHRM Method Office constrained its purpose, the DOD and the VA took different steps to migrate affected individual healthcare information and facts, create interfaces and grant consumer accessibility to Cerner Millennium,” it continued.  

The OIGs suggested that the FEHRM Method Place of work develop processes and treatments in accordance with its constitution, together with:   

  • Analyzing the form of health care data that constitutes a complete EHR 
  • Implementing a prepare for migrating legacy affected individual health care facts desired
  • Utilizing a program for generating interfaces that would let clinical equipment to hook up and transfer affected person healthcare info to Cerner Millennium
  • Applying a plan to modify Cerner Millennium user roles to guarantee that people are granted accessibility to only the affected person health care information and facts essential to complete their job responsibilities  

“The Deputy Secretary of Defense and Deputy Secretary of Veterans Affairs agreed with the advice to critique the actions of the FEHRM System Business and immediate the FEHRM Program Workplace to acquire procedures and procedures in accordance with the suggestions,” reported the auditors.   

“In addition, the Deputy Secretary of Protection and Deputy Secretary of Veterans Affairs mentioned that they would ensure the FEHRM Application Place of work complies with its constitution and relevant NDAA requirements,” they ongoing.

THE Much larger Pattern  

The EHR modernization effort and hard work at the VA has been the subject matter of quite a few OIG reports more than the earlier 12 months, which elevated fears about charge estimates, training deficiencies, scheduling methods, treatment management, ticket-process considerations and care-coordination deficiencies.  

But the DOD’s new EHR implementation also confronted its fair share of watchdog scrutiny about its rollout timeline and its handling of client safety.  

ON THE History  

“As the DOD and the VA continue on to deploy Cerner Millennium, healthcare providers at those people amenities should really be confident that a patient’s EHR is exact and finish no matter of exactly where the place of care transpired,” stated the joint OIG report.

Kat Jercich is senior editor of Health care IT Information.
Twitter: @kjercich
Electronic mail: [email protected]
Health care IT Information is a HIMSS Media publication.