“Objective: The objective of this joint audit was to determine the extent to which the actions taken by the Department of Defense (DoD) and Department of Veterans Affairs (VA) in acquiring and implementing a common, commercial electronic health record (EHR) system and supporting architecture will achieve interoperability between DoD, VA, and external health care providers.”
“Finding: The DoD and VA took action to achieve interoperability of patient health care information across DoD, VA, and external health care providers by acquiring Cerner Millennium, deploying the EHR system at 49 DoD facilities and
one VA health care facility, and launching the Joint Health Information Exchange. However, the DoD and the VA did not take all actions needed to achieve interoperability.”
“Specifically, the DoD and the VA did not:
- consistently migrate patient health care information from the legacy electronic health care systems into Cerner Millennium to create a single, complete patient EHR;
- develop interfaces from all medical devices to Cerner Millennium so that patient health care information will automatically upload to the system from those devices; or
- ensure that users were granted access to Cerner Millennium for only the information needed to perform their duties.
“The DoD and the VA did not take all action necessary to achieve interoperability because FEHRM Program Office officials did not develop and implement a plan to achieve all FY 2020 NDAA requirements or take an active role to manage the program’s success as authorized by its charter. Instead, FEHRM Program Office officials limited their role to facilitating discussions when disputes arose between the DoD and the VA, and would only provide direction if the Departments reported a problem. Because the FEHRM Program Office limited its role, the DoD and the VA took separate actions to migrate patient health care information, develop interfaces, and grant user access to Cerner Millennium…”
“Recommendations: We recommend that the Deputy Secretary of Defense and the Deputy Secretary of Veterans Affairs review the actions of the FEHRM Program Office and direct the FEHRM Program Office to develop processes and procedures in accordance with the FEHRM Program Office charter and the National Defense Authorization Acts. In addition, we recommend, among other actions, that the Director of the FEHRM Program Office, in coordination with the Director of the Defense Health Agency, the Program Executive Director of the VA Office of Electronic Health Record Modernization Integration, and the Program Manager for DoD Healthcare Management System Modernization:
- determine the type of health care information that constitutes a complete EHR;
- develop and implement a plan for migrating legacy patient health care information needed for a patient’s complete EHR once the FEHRM Program Office determines the type of patient health care information that constitutes a complete patient electronic heath record;
- develop and implement a plan for creating interfaces that would allow medical devices to connect and transfer patient health care information to Cerner Millennium; and
- develop and implement a plan to modify Cerner Millennium user roles to ensure that users are granted access to only the patient health care information necessary to perform their job responsibilities…”
Source: Joint Audit of the Department of Defense and the Department of Veterans Affairs Efforts to Achieve Electronic Health Record System Interoperability – May 5, 2022. VA OIG.
