The Defense Department should learn from the problems with its AHLTA medical records system before buying a new system, GAO says.
After spending $2 billion to upgrade its legacy electronic health record system, the Defense Department is preparing to conclude that the effort was only partially successful, according to a new report from the Government Accountability Office. DOD wants a new system, GAO said.
In 1997, DOD began upgrading and adding capabilities to its legacy record system in a project named the Armed Forces Health Longitudinal Technology Application (AHLTA). The system keeps track of records for more than 9 million service members and their family members.
Meanwhile, DOD runs risks in buying a new system without learning the lessons from the first system upgrade, the report warns.
“DOD has initiated efforts to bring its processes into alignment with industry best practices,” the GAO report said. “However, it has not carried out a planned independent evaluation to ensure it has made these improvements. Until it ensures that these weaknesses are addressed, DOD risks undermining the success of further efforts to acquire [EHR] capabilities.”
However, the anticipated new capabilities in AHLTA have been scaled back, including inpatient care management records, and users of the system continue to have problems with low speed, poor usability and unavailability of portions of the system, GAO said.
The department has made plans to improve and stabilize AHTLA through 2015 while it acquires the new EHR system named Way Ahead, GAO said.
The new system is expected to deal with performance problems, provide comprehensive medical documentation, capture and share medical data electronically in DOD, and improve existing information sharing with the Veterans Affairs Department.
As of September 2010, DOD had set up a planning office for Way Ahead and has begun to analyze alternatives for meeting the system requirements. The analysis is due in December.
DOD anticipates choosing a technology solution and setting a schedule for acquisition, with $302 million requested in the fiscal 2011 for Way Ahead.
GAO urged DOD to fix the weaknesses in its management and planning that contributed to AHLTA having fewer capabilities than expected and having experienced persistent performance problems and failing to fully meet users' needs.
Problems with AHLTA included lack of a comprehensive project management plan or tailored systems engineering plan, its requirements were incomplete, and there was no effective plan to improve users’ satisfaction, the report said.
The GAO recommended that the Military Health System CIO:
- Develop and maintain a comprehensive project plan that includes scope, cost, schedule, and risks and update it regularly.
- Develop a systems engineering plan.
- Develop and document a plan for improving user satisfaction.
·DOD officials agreed with the recommendations.